Blocks 1 to 3: office and voucher
The department or establishment, bureau, division or office, plus a voucher number and a schedule number.
OF1164
Claim for Reimbursement for Expenditures on Official Business
- Agency
- GSA
- Revision
- Rev. 11/2017
- Fillable fields
- 369
- Pages
- 2
- Official source
- GSA form page
- Checked
- October 20, 2026
Optional Form 1164 (OF 1164): Claim for Reimbursement for Official Business Expenditures
Optional Form 1164 (OF 1164), Claim for Reimbursement for Expenditures on Official Business, is a claim form for expenses on official business. Its Privacy Act Statement says the primary purpose of the information is to determine payment of reimbursements from the Government. The form names no issuing or prescribing agency, and GSA hosts it in its forms library. Its footer prints OPTIONAL FORM 1164 (REV. 11/2017), and each page is marked CUI when filled in.
The front holds the office and voucher details, the claimant's name, employee ID number, mailing address and office telephone number, and an expenditures table with codes for local travel, telephone or telegraph, other expenses, funeral honors detail and specialty care. The back continues the table and prints the Privacy Act Statement. The claimant, an approving official and an authorized certifying officer each sign the original.
You can fill it out free in your browser on this page and download the result without an account.
What's on OF 1164
Blocks 4 and 5: claimant and paid by
The claimant's name (last, first, middle initial), employee ID number, mailing address with ZIP Code and office telephone number, and a Paid By block.
Block 6: expenditures table
Columns for (a) date, (b) code, (c) from, (d) to, (e) number of miles, (f) mileage, (g) fare or toll, (h) added persons and (i) tips and miscellaneous, with a mileage rate box for whole numbers only.
Expense codes for column (b)
A Local Travel, B Telephone or Telegraph, C Other expenses (itemized), D Funeral Honors Detail and E Specialty Care.
Block 7: amount claimed
The total of columns (f), (g) and (i) in dollars, with subtotals carried forward from the back.
Blocks 8 to 12: approval and payment
Approval, certification for payment, the claimant's certification, a cash payment receipt, payment by check number and an accounting classification line.
How to complete OF 1164
- 1
Enter the office and claimant details
Fill in blocks 1 to 4. The form says to read the Privacy Act Statement on the back of the form.
- 2
List each expenditure
Enter the date, the code, the from and to points and the amounts on one line each. The form says to explain expenditures in specific detail.
- 3
Show added persons
The form says that if a fare or toll claimed in column (g) exceeds the charge for one person, show in column (h) the number of additional persons who accompanied the claimant.
- 4
Use the back for more lines
The form says that if additional space is required, continue on the back, total each column there and enter the totals on the front subtotal line.
- 5
Total the claim
Enter in block 7 the total of columns (f), (g) and (i).
- 6
Sign the original
The claimant signs and dates block 10. Blocks 8, 9 and 10 each say Sign Original Only.
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Where it goes and what the form says
Where it goes
The PDF prints no filing address. Blocks 8 and 9 are for an approving official and an authorized certifying officer.
Authority for the information
The Privacy Act Statement cites Executive Order 11609 of July 22, 1971, Executive Order 11012 of March 27, 1962, Executive Order 9397 of November 22, 1943, and 26 U.S.C. 6011(b) and 6109.
Employee ID number
The form says disclosure is MANDATORY on vouchers claiming payment or reimbursement which is, or may be, taxable income, and voluntary in all other instances.
Missing information
The form says failure to provide the information (other than ID Number) required to support the claim may result in delay or loss of reimbursement.
Handling
Both pages are marked CUI when filled in.
Related forms
Who fills out OF 1164?
The form prints blocks and signature lines for these roles. It gives no filing address.
Official sources and the blank
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Questions about Form OF1164
Who issues OF 1164?
The form names no issuing or prescribing agency. Its footer prints OPTIONAL FORM 1164 (REV. 11/2017), and GSA hosts it in its forms library.
What kinds of expenses does OF 1164 list?
Column (b) of the expenditures table takes one of five codes: A Local Travel, B Telephone or Telegraph, C Other expenses (itemized), D Funeral Honors Detail and E Specialty Care.
How is the amount claimed worked out?
Block 7 is the total of columns (f) mileage, (g) fare or toll and (i) tips and miscellaneous, with subtotals carried forward from the back.
Who signs OF 1164?
The claimant signs block 10, an approving official signs block 8 and an authorized certifying officer signs block 9. Each says Sign Original Only. For a cash payment, the payee signs the receipt in block 11.
Is the employee ID number required?
The Privacy Act Statement says disclosure is MANDATORY on vouchers claiming payment or reimbursement which is, or may be, taxable income, and voluntary in all other instances.
What does the form say about long distance calls?
Block 8 says long distance telephone calls, if shown, are certified as necessary in the interest of the Government, and that 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).