F.10 (15-75) - E. UNITED NATIONS NATIONS UNIES

VOUCHER FOR REIMBURSEMENT OF EXPENSES

To be completed by Controller / Cheque No. / Examiner: / Currency: / Voucher N°:
Amount: / Bank No. / Approving Officer: / Country: / Date:
TO BE COMPLETED BY CLAIMANT (Please TYPE or PRINT) / This space to be filled in by HQ.
PAYEE: / CATEGORY:
Cheque to be:
Called for at CASHIER’s office - Indicate your Tel. Ext. / Dept./Div. or Office:
Mailed to following address: / P.T. 8 or MOD No.:
Mailed to following BANK A/C / Account N°
AND
Payee Advice to be mailed to:
DATE / At-
tach-
ment
N° / DESCRIPTION OF EXPENSES
Tickets purchased, Terminal expenses, Telegrammes, Taxis,
Authorized excess baggage, etc. / LOCAL
CURRENCY / EXCHANGE
RATE / U.S. $
EQUIVALENT / For Financial
Services
Approved Amount
TOTAL TRAVEL ALLOWANCE (See NEXT PAGE)
I claim the subsistence and terminal expenses in connexion with the journey (as indicated on the next page), which I certify
to have been made as authorized. I further certify that all expenses claimed represent actual disbursements made by me, and
dependents indicated, actually travelled as shown. / TOTAL
Signature of Claimant: ______Date: // / LESS ADVANCES
This claim is in conformity with the journey as actually authorized. Payment of subsistence and/or transit allowances, is / BALANCE DUE
approved for all official stopovers and necessary travel time reported by the Claimant on the next page except as otherwise / UN IF ANY
noted by me. / NET PAYMENT
NO EXCEPTIONS / FINAL CLAIM / FOR EXCEPTIONS, NEXT PAGE
Signature of
Admin./Certifying
Officer: ______ Date: //
GENERAL
ACCOUNT / AMOUNT (US.$)
Dr. or Cr* / ALLOTMENT
ACCOUNT / LIQUIDATION
AMOUNT / OBLIGATION
DOCUMENT / DESCRIPTION / I.O.V.
Total Debits /
Total Credits /
Total Liquidations

*Indicate by brackets Submit Claim: - ORIGINAL plus ONE copy to FINANCIAL SERVICES

- ONE copy to CERTIFYING OFFICER

TO BE COMPLETED BY CLAIMANT
ANNUAL LEAVE TO
TO BE CHARGED: / Remarks: List names
and ages of dependents:
Please TYPE or PRINT: Extra sheets should be attached with full explanation
of lengthy or involved travel. Submit a separate Form F.10 if eligible
dependents have itineraries which differ from yours. Subsistence may be / DAYS
subject to a reduction after 60 days under Staff Rules.
Do you have eligible dependents residing with you at your official
duty station? / For Use of Controller ONLY
Yes No
DATE / Indicate
CITY AND COUNTRY / MODE / whether / COMMENTS OF
D / M / Y / H / UN or Govt / ADM./CERTIFYING
OF / OF / A / O / E / O / vehicle was / OFFICER REGARDING
Y / N / A / U / made avail- / STOP-OVERS,
DEPARTURE & ARRIVAL / TRAVEL / T / R / R* / able at DEP / DELAYS, ETC
H / and/or ARR
Yes No
DEP.:
ARR.:
Official -
Personal -
DEP.:
ARR.:
Official -
Personal -
DEP.:
ARR.:
Official -
Personal -
DEP.:
ARR.:
Official -
Personal -
DEP.:
ARR.:
Official -
Personal -
DEP.:
ARR.:
Official -
Personal -
DEP.:
ARR.:
Official -
Personal -
DEP.:
ARR.:
Official -
Personal -
REMARKS: (List here attached unused tickets by stating ticket / Total Travel Allowance in US$ …………………………..
number and the route covered by the ticket.) / Value of MCO’s received: / US$
Value of MCO’s used: / US$
BALANCE OF MCO’s to be
returned to the U.N. : / US$
The balance of the MCO’s is represented by the following
coupon numbers: