OF1012
Travel Voucher
Optional Form 1012 (OF 1012), Travel Voucher, is printed as OPTIONAL FORM 1012 (REV. 10/2016). The form names no issuing agency; GSA hosts it in its forms library.
The front identifies the department or office, the type of travel (temporary duty or permanent change of station), the traveler as payee, the period of travel and the travel authorization, then records travel advances, cash payment, government transportation requests or tickets, and the signatures of the traveler, the approving official and the authorized certifying official, with a block for finance office use only.
The back is the Schedule of Expenses and Amounts Claimed, with columns for meals, lodging, miscellaneous subsistence, mileage and other expenses, and the Privacy Act statement. The form says the total of columns (l), (m) and (n) is entered in item 13 on the front. You can fill it out free in your browser on this page and download the result without an account.
Department or office, type of travel, voucher and schedule numbers, the traveler's name, Social Security number, mailing address, office telephone, duty station and residence, the period of travel and travel authorization numbers and dates.
The travel advance outstanding, amount applied, amount due the Government and balance, a cash payment receipt with the payee's signature, check number and paid by.
Government transportation requests, or tickets purchased with cash, listed by agent's valuation, issuing carrier, mode and class, date issued and points of travel.
The traveler's certification and amount claimed, approval, the last preceding voucher paid under the same travel authorization, certification for payment, finance office computation and accounting classification.
Date, time and description, then breakfast, lunch, dinner, miscellaneous subsistence, lodging, mileage rate and number of miles, and the amount claimed for mileage, subsistence and other, with totals.
Enter the office, check temporary duty or permanent change of station, and complete the traveler, period of travel and travel authorization items.
On the back, show each meal including tax and tips in columns (d) to (g), other subsistence such as laundry in (h), lodging in (i), and items such as taxi fares, car rental and business calls in (n).
The instructions say that if per diem is claimed for the employee's immediate family, column (c) shows their names, ages, relationship and the marital status of children, unless already on the travel authorization.
Enter the total of columns (l), (m) and (n) at the bottom of the back and in item 13 on the front. For more space, the form says to continue on another OF 1012 back, leaving the front blank.
The traveler signs and dates item 13. The approving official signs item 14, and the authorized certifying official signs item 16.
These steps follow the Instructions to Traveler on the back and the blocks on the front.
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
The PDF gives no filing address. It routes through the approving official, the authorized certifying official and the finance office.
The form says falsification of an item in an expense account works a forfeiture of claim (28 U.S.C. 2514) and may result in a fine of not more than $10,000 or imprisonment for not more than 5 years or both (18 U.S.C. 287; i.d. 1001).
If long distance telephone calls are included, the form says the approving official must have been authorized in writing by the head of the department or agency to so certify (31 U.S.C. 680a).
The Privacy Act statement says disclosure of the SSN is MANDATORY on vouchers claiming travel or relocation allowance expense reimbursement which is, or may be, taxable income, and voluntary in all other instances.
The form cites E.O. 11609 of July 22, 1971, E.O. 11012 of March 27, 1962, E.O. 9397 of November 22, 1943, and 26 U.S.C. 6011(b) and 6109, and says failure to provide supporting information may result in delay or loss of reimbursement.
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The form prints signature blocks for four roles.
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The form is printed as OPTIONAL FORM 1012 (REV. 10/2016) and names no issuing agency. GSA hosts a copy in its forms library.
The traveler signs item 13, the approving official signs item 14, and the authorized certifying official signs item 16. A payee signature also appears in the cash payment receipt, item 9.
Yes, in item 5b. The Privacy Act statement says disclosure is MANDATORY on vouchers claiming travel or relocation expense reimbursement which is, or may be, taxable income, and voluntary in all other instances.
The form says if additional space is required, continue on another Optional Form 1012 BACK, leaving the front blank, and complete the page, travel authorization number and traveler's last name boxes.
It says falsification of an item in an expense account works a forfeiture of claim (28 U.S.C. 2514) and may result in a fine of not more than $10,000 or imprisonment for not more than 5 years or both.
Column (k) has the mileage rate in cents and the number of miles, and column (l) the mileage amount claimed.