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Currency [0]/Explanatory TextG5Explanatory Text % 0Good;Good  a%1 Heading 1G Heading 1 I}%O2 Heading 2G Heading 2 I}%?3 Heading 3G Heading 3 I}%234 Heading 49 Heading 4 I}% 5InputuInput ̙ ??v% 6 Linked CellK Linked Cell }% 7NeutralANeutral  e%"Normal 8Noteb Note   9OutputwOutput  ???%????????? ???:$Percent ;Title1Title I}% <TotalMTotal %OO= Warning Text? Warning Text %XTableStyleMedium9PivotStyleLight16`QcForm 19 - Travel:Page 2  ;4  ; 5m CLAIM OF:STATE OF OKLAHOMAFOR AGENCY USE:FORAGAINST Comm., Dept. ASSIGNMENTI hereby assign this claim toQand authorize the State Treasurer to issue a warrant in payment to said assignee.Claimant SignatureAMOUNTIS CAR GOV. OWNED?YESNO)IS CLAIMANT A STATE OFFICIAL OR EMPLOYEE?DateITEMIZED LOCAL TRANSPORTATIONTAXI:SHUTTLE: RENTAL CAR:OTHER LOCAL TRANSP: TELEPHONE:TOLLS:PARKING:OTHER MISC. COSTS:I,ITEMIZED MISCELLANEOUS COSTS Total AmountAGENCY BUSINESSUNIT OBJECT ACCT Sub-TotalSub-Total IN-STATE OUT-OF-STATE$521110 Mileage 521120 Per Diem 521130 Public Trans 521140 Misc 521150 Lodging 521310 All Travel 521210 Mileage 521230 Per Diem 521240 Local Trans 521220 Transp 521250 Misc. 521260 Lodging NATURE OF OFFICIAL BUSINESS:TOTAL PUBLIC TRANSP.:REGISTRATION FEE:TOTAL ITEMIZED MISC.TOTAL LOCAL TRANSP. Agency, Bd., NON-EMPLOYEEAddress:Travel Voucher*Manager's Approval Signature (If required)Kof perjury, declare that the information contained in this document and any|Exempt from Trip Optimizer+Trip Optimizer Used for Mileage Comparison Vendor I.D. #:", by signing here do under penalty l>>MUST ATTACH COPY OF TRIP OPTIMIZER RESULTS TO THE VOUCHER. (ALSO, UNAVAILABILITY NOTICE OF RENTAL CAR) <<ij6 (Place 'X' in appropriate box per Title 74, 85.45l)\* Must be lowest amount from the Trip Optimizer results. (Multiple trips total if necessary)S>>For accurate results the optimizer calculation must be performed prior to trip <<R OMES FORM 19Lodging AmountPer DiemRateYearMo.Day TOTAL MILESPER DIEM TOTAL LODGING TOTAL.*MILEAGE TOTAL AFTER TRIP OPTIMIZER ADJUSTMENTRATE (PER MILE)DUTY STATION ADDRESS:yShow city/town point travel status began, each point visited and the point travel status ended. (For mileage - see below)]ALL MILEAGE CLAIMED SHOULD BE BASED ON GPS MILES OR ACTUAL MILES DRIVEN PER ODOMETER READINGS1. If GPS printouts are attached to the claim, record the travel as city to city and record the GPS mileage for each trip. The odometer reading is not required when GPS printouts are attached to the claim.2. If GPS printouts are not attached to the claim, record the specific addresses traveled to/from and the mileage for each trip. Odometer readings are not required when mileage is based on GPS miles.k3. If GPS is not available and odometer readings are used, complete all columns for each location visited.4. If specific addresses are not available due to the nature of travel (eg. construction site inspections and similar circumstances), record the city traveled to/from and the odometer reading for each trip.=5. If the address traveled must be kept confidential, record the city name and note that travel is to a confidential address, e.g., Ada (confidential address). Complete all columns of this sheet based on odometer readings. Confidential addresses should be kept on file at the agency in case further review is needed.Beginning LocationEnding LocationOdometer Start Odometer End Miles Driven Less Personal Miles Claimed(if GPS not used)(or GPS miles)Iattachments are true and correct to the best of my knowledge and belief. Meals Provided BreakfastLunchDinner (Revised 11/22)sMileage Instructions: For detailed mileage (addresses, odometer readings) please use Page Two of the OMES Form 19.PUBLIC TRANSPORTATION Mileage ClaimedMealsBaseTotalrT TGUOU    !$"#######$Chhhhi *8 %&&&&&&&&' H7c+   !     "     Ce 3 33p  ,        Vt -# ./X   $     * 6@m012A ? O  %     - 6de E EEU ? O  &     + 6 Z5[MNNO FF  '     , 6 \ ]PPPQ    (     . 6 K LLLL  45   / 6 D >>>>n  A6$ <6LMMMMo ?  :) ;B<6 F GGGGf ? Pg9B 7 8  # HIIJJF?F T U S#D C D  # g P  0$s"  g.CJJJJg"R jjg =Q~~~> }H~ =i>  b F  =E>?@ I J ?@  c  d  e G k j l ?@.zz.\\.qq.\\.qq.\\.qq.\\.qq.\\D ljjTTzZzzp^HrpTH2H2222222<2 @!@ "@ #@ $@ %@0&@'@(@ )@*@+@ ,@ -@ .@ /@0@1@2@3@4@567;. \\\\.! 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