Ostandart Form 1164 – Fill Out and Use This PDF

The Ostandart 1164 form is a detailed document utilized for claiming reimbursement for expenditures incurred during official business. It requires comprehensive information about the claimant, such as departmental details, personal identification, and a breakdown of the expenses being claimed. This form serves as a crucial tool for financial transparency and accountability within governmental or related establishments. To ensure a smooth reimbursement process, fill out the Ostandart 1164 form accurately by clicking the button below.

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Ostandart Form 1164 PDF Details

In a world where bureaucratic procedures and paperwork are a part of every government employee's life, understanding the nuances of specific forms can be both crucial and daunting. Among the myriad of forms is the Ostandart 1164 form, a critical document for those seeking reimbursement for expenditures incurred on official business. This form outlines a structured way for employees to claim back money spent during the course of their duties, covering various categories of expenses such as local travel, telephone or telegraph costs, and even specific ones like funeral honors detail or specialty care. It requires detailed information from the claimant, including name, employee ID number, and a thorough breakdown of the expenditures claimed. The process is safeguarded with sections for the approval and certification of authenticity and necessity by appropriate officials, underlining the government's efforts to ensure accountability and prevent misuse of funds. Also, respecting privacy concerns, it includes a Privacy Act Statement, explaining the authority under which the information is collected and its intended use, reassuring employees about the confidentiality and security of their personal information. Parsing through the Ostandart 1164 form reveals not just a means for reimbursement but a microcosm of government operations' broader principles of transparency, accountability, and privacy.

Question	Answer
Form Name	Ostandart Form 1164
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	form 1164 claim, gsa form sf 1164, gsa sf 1164, form sf 1164 form

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		1. DEPARTMENT OR ESTABLISHMENT, BUREAU, DIVISION OR OFFICE		2. VOUCHER NUMBER
	CLAIM FOR REIMBURSEMENT
	FOR EXPENDITURES
	FOR EXPENDITURES			3. SCHEDULE NUMBER
				3. SCHEDULE NUMBER
	ON OFFICIAL BUSINESS

	Read the Privacy Act Statement on the back of this form.			5. PAID BY

4.	a. NAME (Last, first, middle initial)		b. EMPLOYEE ID NUMBER
C
L
A
I	c. MAILING ADDRESS (Include ZIP Code)		d. OFFICE TELEPHONE NUMBER
M
A
N
T

6.EXPENDITURES (If fare or toll claimed in column (g) exceeds charge for one person, show in column (h) the number of additional persons which accompanied the claimant.)

DATE

Show appropriate code in column (b):

D. Funeral Honors Detail

MILEAGE RATE

AMOUNT CLAIMED

A - Local Travel

(Enter Whole

B - Telephone or Telegraph

E. Specialty Care

Numbers Only)

C - Other expenses (itemized)

FARE

(Explain expenditures in specific detail.)

NUMBER OF

ADD

TIPS AND

(a)

(b)

MILES

MILEAGE

TOLL

PERSONS MISCELLANEOUS

(d) TO

(e)

(f)

(g)

(h)

(i)

If additional space is required continue on the back.		SUBTOTALS CARRIED FORWARD FROM THE
			BACK

7. AMOUNT CLAIMED (Total of columns (f), (g) and (i).)		$		TOTALS
7. AMOUNT CLAIMED (Total of columns (f), (g) and (i).)		$


8. This claim is approved. Long distance telephone calls, if shown, are certified as				10. I certify that this claim is true and correct to the best of my knowledge and belief
necessary in the interest of the Government. (Note: If long distance calls are				and that payment or credit has not been received by me.
included, the approving official must have been authorized in writing, by the head				and that payment or credit has not been received by me.

of the department or agency to so certify (31 U.S.C. 680a).)					Sign Original Only
							DATE
							DATE
	Sign Original Only			CLAIMANT
	Sign Original Only			SIGN HERE
				SIGN HERE
		DATE
		DATE		11.	CASH PAYMENT RECEIPT
				11.	CASH PAYMENT RECEIPT
APPROVING
APPROVING				a. PAYEE (Signature)		b. DATE RECEIVED
OFFICIAL
SIGN HERE

9. This claim is certified correct and proper for payment.						c. AMOUNT
AUTHORIZED	Sign Original Only					$
CERTIFYING		DATE		12. PAYMENT MADE
OFFICER				12. PAYMENT MADE
OFFICER				BY CHECK NUMBER
SIGN HERE				BY CHECK NUMBER
SIGN HERE

ACCOUNTING CLASSIFICATION

OPTIONAL FORM 1164 (REV. 11/2017)

6. EXPENDITURES -- Continued

DATE

(a)

C	Show appropriate code in column (b):	D. Funeral Honors Detail
C	A - Local Travel	D. Funeral Honors Detail		MILEAGE
O	B - Telephone or Telegraph	E. Specialty Care		RATE
D	C - Other expenses (itemized)			C
E
E	(Explain expenditures in specific detail.)			NUMBER OF
	(Explain expenditures in specific detail.)			NUMBER OF
				MILES
(b)	(c) FROM		(d) TO	(e)

AMOUNT CLAIMED

	FARE
	OR	ADD	TIPS AND
MILEAGE	TOLL	PERSONS MISCELLANEOUS
(f)	(g)	(h)	(i)

Total each column and enter on the front, subtotal line.

In compliance with the Privacy Act of 1974, the following information is provided: Solicitation of the information on this form is authorized by Executive Order 11609 of July 22, 1971, Executive Order 11012 of March 27, 1962, Executive Order 9397 of November 22, 1943, and 26 U.S.C. 6011(b) and 6109. The primary purpose of the requested information is to determine payment of reimbursements from the Government. The information will be used by Federal agency officers and employees who have a need for the 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. An Employee Identification (ID) Number is solicited under the authority of the Internal Revenue Code (26 U.S.C. 6011(b) and 6109) and Executive Order 9397, November 22, 1943, for use as a taxpayer and/or identification number. Disclosure is MANDATORY on vouchers claiming payment or reimbursement which is, or may be, taxable income. Disclosure of your ID Number and other requested information is voluntary in all other instances. Failure to provide the information (other than ID Number) required to support the claim may result in delay or loss of reimbursement.

OPTIONAL FORM 1164 (REV. 11/2017) BACK

How to Edit Ostandart Form 1164 Online for Free

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This form will need specific information; to ensure accuracy, please be sure to pay attention to the recommendations just below:

1. To begin with, when completing the sf 1164 claim reimbursement form, beging with the form section with the subsequent blanks:

2. After this segment is finished, it is time to include the needed specifics in If additional space is required, SUBTOTALS CARRIED FORWARD FROM THE, BACK, AMOUNT CLAIMED Total of columns f, TOTALS, This claim is approved Long, I certify that this claim is true, Sign Original Only, DATE, Sign Original Only, CLAIMANT SIGN HERE, APPROVING, OFFICIAL SIGN HERE, This claim is certified correct, and DATE in order to go to the 3rd stage.

Step no. 2 in filling out form 1164 claim

3. This next step will be about AUTHORIZED CERTIFYING, OFFICER SIGN HERE, Sign Original Only, ACCOUNTING CLASSIFICATION, DATE, PAYMENT MADE BY CHECK NUMBER, and OPTIONAL FORM REV - fill out all these blanks.

Guidelines on how to prepare form 1164 claim stage 3

4. To move forward, your next stage involves filling in a handful of empty form fields. Included in these are DATE, C O D E b, Show appropriate code in column b, D Funeral Honors Detail E, Explain expenditures in specific, c FROM, d TO, AMOUNT CLAIMED, MILEAGE, RATE, c NUMBER OF, MILES, MILEAGE, FARE OR TOLL, and ADD, which you'll find essential to continuing with this form.

form 1164 claim writing process clarified (stage 4)

When it comes to ADD and C O D E b, make sure that you do everything correctly in this section. These could be the key ones in the file.

5. The final notch to submit this form is integral. Make sure that you fill in the necessary fields, for instance , prior to finalizing. Failing to do so can produce a flawed and potentially invalid form!

Step number 5 of filling out form 1164 claim

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Ostandart Form 1164 – Fill Out and Use This PDF

Ostandart Form 1164 PDF Details

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