pliance with the Privacy Act of 1974, the following information is provided. Solicitation of the information on this form is authorized by 5 USC Chapter 57 as implemented by the d Travel Regulations (FPMR 101-7), E.O. 11609 of July 22, 1971, EO. 11012 of March 27, 1962. E O. 9397 of November 22, 1943, and 26 USC 6011(b) and 6109. The primary ⚫ of the requested information is to determine payment or reimbursement to eligible individuals for allowable travel and/or other expenses incurred under appropriate authorization and to record and maintain costs of such reimbursements to the Government. The information will be used by Federal agency officers and employees who have information in the performance of their official duties. The information may be disclosed to appropriate Federal, State, local, or foreign agencies, when relevant to crvd, Criminal, Latory investigations or prosecutions, or when pursuant to a requirement t y this agency in connection with the hiring or firing of an employee, the issuance of a security clearance, or sations of the performance of official duty while in Government service. Your Social Security Account Number (SSN) is solicited under the authority of the Internal Revenue Code (26 6011(b) and 6109) and EO 9397, November 22, 1943, for use as a taxpayer and/or employer identification number, disclosure is MANDATORY on vourdes Claiming stor reimbursement which is, or may be, taxable income Dclosure of your SSN and uter requested information is voluntary in all other unlances, however, falure to provide rmation (other than SSN) required to support the claim may result in delay or loss of reimbursement. EXPENDITURES (If fare claimed in col. (g) exceeds charge for one person, show in col. (h) the number of additional persons which accompanied the claimant) mpliance with the Privacy Act of 1974, the following information is provided. Solicitation of the information on this form is authorized by 5 U.S.C. Chapter 57 as implemented by the ravel Regulations (FPMR 101-7), E.O. 11609 of July 22, 1971, EO. 11012 of March 27, 1962. E.O. 9397 of November 22, 1943, and 26 U.S.C. 6011(b) and 6109 The primary the requested information is to determine payment or reimbursement to eligible individuals for allowable travel and/or other expenses incurred under appropmate ative authonzation and to record and maintain costs of such reimbursements to the Government The information will be used by Foderal agency officers and employees who have d for the information in the performance of the official duties. The information may be disclosed to appropriate Federal, Stato, local, or foreign agencies, when relevant to civil, criminal, Tulatory investigations or prosecutions, or when pursuant to a requirement by this agency in connection with the hiring or firing of an employee, the issuance of a security clearance, of ligations of the performance of official duty while in Government service Your Social Security Account Number (SSN) is solicited under the authority with internal Revenue Live (26 7.6011(b) and 6109) and EO. 9397, November 22, 1943, for use as a laxpayer and/or employee identification number, disclosure is MANDATORY on vouchers claiming ent or reimbursement which is, or may be, taxable income Disclosure of your SSN and other requested information is voluntary in all other instances, however, failure to provide formation (other than SSN) required to support th um may result in delay or loss of reimbursement |