Omes Form 19 PDF Details

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.

QuestionAnswer
Form NameOmes Form 19
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesOptimizer, CLAIMANT, mdhs new travel trip optimizer, tation

Form Preview Example

MUST BE ATTACHED TO A CLAIM JACKET VOUCHER FORM 15A OTHER AUTHORIZED COVER FORM

OMES FORM 19

 

AGENCY BUSINESS

 

CLAIM OF:

(Revised 12/12)

 

 

UNIT

 

Vendor I.D. #:

STATE OF OKLAHOMA

FOR AGENCY USE:

 

 

 

 

 

 

 

 

Travel Voucher

 

 

 

 

 

Address:

 

 

 

 

IN-STATE

 

OUT-OF-STATE

 

FOR

 

IS CAR GOV.

OBJECT ACCT

AMOUNT

 

OBJECT ACCT

AMOUNT

 

$

 

 

 

OWNED?

521110 Mileage

 

 

521210 Mileage

 

 

 

 

 

 

YES

 

 

521120 Per Diem

 

 

521220 Transp

 

 

AGAINST

 

 

NO

521130 Public Trans

 

 

521230 Per Diem

 

Agency, Bd.,

 

 

 

 

521140 Misc

 

 

521240 Local Trans

 

Comm., Dept.

 

LICENSE NO.:

521150 Lodging

 

 

521250 Misc.

 

 

ASSIGNMENT

 

 

 

 

 

 

 

521260 Lodging

 

I hereby assign this claim to

 

IS CLAIMANT A STATE

NON-EMPLOYEE

 

 

 

 

 

 

 

OFFICIAL OR EMPLOYEE?

521310 All Travel

 

 

 

 

and authorize the State Treasurer to issue a warrant in payment

 

YES

 

 

 

 

 

 

 

to said assignee.

 

 

 

 

 

 

 

 

 

 

 

NO

Sub-Total

$

 

Sub-Total

$

 

 

 

 

 

 

 

 

OSF-Audited By:

 

 

Total Amount

$

Claimant Signature

 

 

 

 

 

 

 

 

 

 

OFFICIAL DUTY STATION:

NATURE OF OFFICIAL BUSINESS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

 

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)

 

Date

Mileage

Travel Status

Number

 

Per-Diem

Year

 

 

Claimed

Hour

 

 

of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mo.

 

Day

Map

Vicinity

Entered

 

Ended

Days

 

Hrs

Rate

 

Amount

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Lodging

Amount

TOTAL

PER DIEM / LODGING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTALS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL MILES @

¢

Per Mile = $

 

* Results $

 

 

 

 

 

 

 

 

Trip Optimizer Used for Mileage Comparison

 

Exempt from Trip Optimizer

 

(Place 'X' in appropriate box per Title 74, § 85.45l)

* Must be lowest amount from

the Trip

Optimizer results. (Multiple trips total if necessary)

 

>>MUST ATTACH COPY OF TRIP OPTIMIZER RESULTS TO THE VOUCHER. (ALSO, UNAVAILABILITY NOTICE OF RENTAL CAR) <<

 

>>For accurate results the optimizer calculation must be performed prior to trip < <

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MODE OF PUBLIC TRANSPORTATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AGENCY DIRECT PURCHASE:

 

(X)

 

 

 

TOTAL PUBLIC TRANSP.:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ITEMIZED LOCAL TRANSPORTATION

 

ITEMIZED MISCELLANEOUS COSTS

 

 

 

 

 

 

 

TAXI:

 

REGISTRATION FEE:

 

 

 

(# of meals included in Registration

)

SHUTTLE:

 

 

TELEPHONE:

 

 

 

 

 

 

 

 

 

RENTAL CAR:

 

 

PARKING:

 

 

 

 

 

TOTAL ITEMIZED MISC.

 

OTHER LOCAL TRANSP:

 

 

 

TOLLS:

 

 

 

 

 

TOTAL LOCAL TRANSP.

 

 

 

OTHER MISC. COSTS:

 

 

 

TOTAL AMOUNT CLAIMED

 

 

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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