In the intricate framework of government administration, the Omes 19 form emerges as a crucial document for facilitating detailed accountability and reimbursement processes for state employees in Oklahoma. Primarily attached to a claim jacket voucher form 15A or another authorized cover form, this refined document serves as a comprehensive vehicle for agency business claims, meticulously covering aspects from travel vouchers to in-state and out-of-state travel expenses. Revised as of December 2012, it diligently records various expenses including mileage, per diem, and lodging under specific object account numbers, ensuring that financial transactions are tracked with precision. The form obliges claimants to specify whether the travel involved government-owned vehicles and requests detailed information on the nature of official business, alongside the claimant’s affiliation with the state as an employee or official. Moreover, it requires an assignment section to be filled, authorizing the State Treasurer to issue payment to the designated assignee. This document further integrates a segment for auditing by the OSF, underscoring its role in the rigorous oversight of state expenditure. Emphasizing accuracy, it mandates the attachment of Trip Optimizer results, underscoring the state’s commitment to cost efficiency in travel expenses. Through capturing detailed travel data, including dates, destinations, and expenditures, down to the necessity for a miscellaneous expenses breakdown, the Omes 19 form epitomizes the meticulous approach adopted by the State of Oklahoma to manage public funds with transparency and integrity.
Question | Answer |
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Form Name | Omes Form 19 |
Form Length | 1 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 15 sec |
Other names | Optimizer, CLAIMANT, mdhs new travel trip optimizer, tation |
MUST BE ATTACHED TO A CLAIM JACKET VOUCHER FORM 15A OTHER AUTHORIZED COVER FORM
OMES FORM 19 |
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AGENCY BUSINESS |
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CLAIM OF: |
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(Revised 12/12) |
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UNIT |
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Vendor I.D. #: |
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STATE OF OKLAHOMA |
FOR AGENCY USE: |
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Travel Voucher |
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Address: |
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FOR |
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IS CAR GOV. |
OBJECT ACCT |
AMOUNT |
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OBJECT ACCT |
AMOUNT |
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$ |
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OWNED? |
521110 Mileage |
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521210 Mileage |
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YES |
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521120 Per Diem |
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521220 Transp |
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AGAINST |
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NO |
521130 Public Trans |
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521230 Per Diem |
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Agency, Bd., |
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521140 Misc |
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521240 Local Trans |
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Comm., Dept. |
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LICENSE NO.: |
521150 Lodging |
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521250 Misc. |
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ASSIGNMENT |
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521260 Lodging |
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I hereby assign this claim to |
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IS CLAIMANT A STATE |
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OFFICIAL OR EMPLOYEE? |
521310 All Travel |
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and authorize the State Treasurer to issue a warrant in payment |
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YES |
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to said assignee. |
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NO |
$ |
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$ |
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Total Amount |
$ |
Claimant Signature |
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OFFICIAL DUTY STATION: |
NATURE OF OFFICIAL BUSINESS: |
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Date |
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Show point travel status began, each point visited and the point travel status ended. (Vicinity only travel should show general geographical area, e.g., Tulsa Vicinity)
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Date |
Mileage |
Travel Status |
Number |
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Year |
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Claimed |
Hour |
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of |
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Mo. |
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Day |
Map |
Vicinity |
Entered |
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Ended |
Days |
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Hrs |
Rate |
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Amount |
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Lodging
Amount
TOTAL
PER DIEM / LODGING
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TOTALS |
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TOTAL MILES @ |
¢ |
Per Mile = $ |
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* Results $ |
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Trip Optimizer Used for Mileage Comparison |
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Exempt from Trip Optimizer |
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(Place 'X' in appropriate box per Title 74, § 85.45l) |
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* Must be lowest amount from |
the Trip |
Optimizer results. (Multiple trips total if necessary) |
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>>MUST ATTACH COPY OF TRIP OPTIMIZER RESULTS TO THE VOUCHER. (ALSO, UNAVAILABILITY NOTICE OF RENTAL CAR) << |
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>>For accurate results the optimizer calculation must be performed prior to trip < < |
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MODE OF PUBLIC TRANSPORTATION |
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AGENCY DIRECT PURCHASE: |
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(X) |
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TOTAL PUBLIC TRANSP.: |
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ITEMIZED LOCAL TRANSPORTATION |
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ITEMIZED MISCELLANEOUS COSTS |
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TAXI: |
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REGISTRATION FEE: |
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(# of meals included in Registration |
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SHUTTLE: |
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TELEPHONE: |
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RENTAL CAR: |
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PARKING: |
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TOTAL ITEMIZED MISC. |
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OTHER LOCAL TRANSP: |
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TOLLS: |
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TOTAL LOCAL TRANSP. |
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OTHER MISC. COSTS: |
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TOTAL AMOUNT CLAIMED |
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I,, by signing here do under penalty
of perjury, declare that the information contained in this document and any attachments are true and correct to the best of my knowledge and belief. I also certify that no frequent travel miles earned from any official state transpor- tation have been used for personal transportation purposes.
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Claimant Signature |
Date |
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Manager's Approval Signature (If required) |
Date |
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