FormFlow 1.001i2 Agency @. "EmpName @. "SepDate E/ "OrgUnit @. "TranRequest @. "GovBillLad @. "ParkPermit @.  "DrLicense @.  "OthAccDoc @. "Property @. "Remarks @. "OthIndebt @. "GAOExcept @. "FiscLiab @. "ItCertif @. "SigTitles @. "IDDatec E/ "USDAInsp@ ß:ß:" ß:ß: IDCardOth@ dğ:dğ:" zğ:zğ: Gasoline@ $ş: $ş:" :ş::ş: Phonet@ ş: ş:" ş:ş: CCOther@ Ɵ: Ɵ:" Ɵ:Ɵ: TrOffStat@ dǟ:dǟ:" zǟ:zǟ: FirstPost@ $ȟ:$ȟ:" :ȟ::ȟ: Training@ ɟ:ɟ:" ɟ:ɟ: ImFundAd@ Vʟ:Vʟ:" lʟ:lʟ: CollOffR@ ͟:͟:" ͟:͟: LeaveAud@ jΟ:jΟ:" Ο:Ο: FPartAd@ *ϟ:*ϟ:" @ϟ:@ϟ: TrAdvance@ ϟ:ϟ:" П:П: IDOthSpec @. ҏT@ҏT  TT[IDCardOth]CCOthSpec @. T@T  TT[CCOther]"TSwiss"Univers (WN)#CG Times (WN)Univers Condensed"CG TimesUnivers Cd (W1)"Courier New1YaHHH$Cc18cԔp )D[/^\1a @:IC@:IC6. CREDIT CARDS Qq/uw1a :%`JC:`JC12. SERVICE AGREEMENTS FULFILLED /V 6V1a :|C:|C9. FUNDS /0Gb1a ݟ:n}Cݟ:n}C2. IDENTIFICATION CARDS /t"d 1a  gRJ~CgRJ~CFINAL SALARY PAYMENT REPORTPE EAdministrative Offset Procedures permit holding final paycheck and/or leave until accountable documents are returnedt"/C 1a  EmpName Z۟:CZ۟:CEMPLOYEE NAME C/d 1a  SepDate ۟:C۟:CSEPARATION DATE d/ 11a  OrgUnit ܟ:lCܟ:lCORGANIZATIONAL UNIT /6G1a  TranRequest ݟ:@Cݟ:@C1. TRANSPORTATION REQUESTS /0(bbr1a  GovBillLad ^ޟ:""C^ޟ:"C3. GOVERNMENT BILLS OF LADING /(bÓr1a  ParkPermit ߟ: Cߟ: C4. PARKING PERMIT /Ó^1a  DrLicense ߟ:$Cߟ:C5. DRIVERS LICENSE (GOVERNMENT) /\1a  OthAccDoc :-C:C7. OTHER ACCOUNTABLE DOCUMENTS (SPECIFY) /1a  Property T:CT:C8. PROPERTY o/1a  Remarks :RC:RCREMARKS CY v/o1a  OthIndebt x:Cx:C13. OTHER INDEBTEDNESS V /?Vg1a  GAOExcept :C:C10. GAO EXCEPTION ?/Qqgw1a  FiscLiab @:C@:C11. FISCAL LIABILITY //&&1a  ֍T9T֍TTCERTIFICATION: I certify that the identified items have been checked against official records, except as noted, the above- named employee has properly accounted for each item. Action has been taken to revoke existing delegations of authority and any assignment under the Department's position schedule bond./(&H81a:-C:CITEMS BEING CERTIFIED (List by No. below)(&H81a:8T:TSIGNATURE AND TITLE OF OFFICIAL MAKING CERTIFICATION(&/H1a,:T,:TDATE. below/HE8:13a/Hj81  ItCertif  ::LTLTHE8:13aqܬ8%/1  SigTitles ::TTTTޒTTޒTT(TTT(TTT*TT*TTORIGINATING OFFICE PERSONNEL ADMINISTRATIVE FINANCE H/E:13a۬/E/:1  IDDatec  ::/d 11a  Agency b:Cb:CAGENCY '@; 1a Gasoline  'W@;\ 1a Phone  '@; 1a CCOther  'O:/B/HCoC~:7/H_H~:'O:/B/HvB{}1a TrOffStat  B1a FirstPost  B1a Training  ')@;. NQ1a USDAInsp  '@;  SW1a IDCardOth  WB\GK1a ImFundAd  BLP1a CollOffR  BRU1a LeaveAud  BBE1a FPartAd  jBo<@1a TrAdvance  //161a  T;TTTITEMS REQUIRING CLEARANCE PRIOR TO FINAL SALARY PAYMENT>gMQX13>gMQR1  HCHCCjCCjCCCCCa. USDA IDENTIFICATIONb. OTHER (SPECIFY)ڟL04Rba  IDOthSpec  jgR|gRjgR|gR>  Q13> Q1  CC(CC(CC<CC<CCC@CC@Ca. GASOLINEb. TELEPHONEc. OTHER (SPECIFY)> L\a  CCOthSpec  "gR"gRf/V <V13fD/LQ1  CCC@CC@C6GCC6GCCCnICCnICC"(CC(C<CC<CCa. TRAVEL ADVANCEb. FIELD PARTY ADVANCEc. IMPREST FUND ADVANCEd. COLLECTION OFFICER RECEIPTSe. LEAVE AUDIT/AD-581fځ/t|13fc/1  8C8CC#CCCJCCJCCCvCCvCa. TRANSFER OF OFFICIAL STATIONb. FIRST POST OF DUTYc. TRAININGeF/ :?a TTTTAD-139 (USDA) (REV. 10/86)