FINANCIAL SYSTEM/DIRECT DEPOSIT FORM FOR TRAVEL
PRIVACY ACT STATEMENT: This statement is provided pursuant to the Privacy Act
of 1974, 5 USC § 552a.
AUTHORITY: Solicitation of the information on this form is authorized by 5 U.S.C.
Chap. 57 as implemented by the Federal Travel Regulations (FPMR 101-7), E.O.
11609 of July 22, 1971, E.O. 110012 of March 27, 1962, E.O. 9397 of November
22, 1943, and 26 U.S.C. 6011(b) and 6109.
PURPOSE: The primary purpose of the requested information is to determine
payment or reimbursement to eligible individuals for allowable travel and/or
relocation expenses incurred under appropriate administrative authorization and
to record and maintain costs of such reimbursements to the Government.
ROUTINE USE(S): The information will be used by officers and employees who
have a need for information in the performance of their official duties. The
information may be disclosed to appropriate Federal, State, local, or foreign
agencies when relevant to civil, criminal or regulatory 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, or
investigations 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 U.S.C. 6011 (b) and 6109) and E.O. 9397, November
22, 1943, for use as a taxpayer and/or employee identification number;
DISCLOSURE: Disclosure is MANDATORY on vouchers claiming travel and/or
relocation allowance expense 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 the information (other than SSN)
required to support the claim may result in delay or loss of reimbursement.