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/-av <br />FC: 4770 <br />REQUEST AND AUTHORIZATION FOR ACTIVE DUTY TRAINING/AC11VE DUTY TOUR <br />(THIS FORT IS SUBJECT TO THE PRIVACY ACT OF 197d • USE BLANKET PAS • AF FORN 11) <br />1. 1 of A.,ranw.eD <br />7. �pPwOVd NeplF'lA�L lR�•, Orw., slwNw• and D•1.1j <br />DER OF THE SECRETARY <br />446AMSDnO <br />MCCHORD AFB WA <br />V(I/CKKIS.\OKINO; SSGT, USAFR 12 Jul 85E <br />AIR FORCE <br />S, GRADE. NAME (Los', ph.l. AG). SSAN <br />e. PRlfC NADDRESS <br />SECURITY CLEARANCESSG <br />PIERRE, ROBERT R. <br />8016 Beverly Blvd <br />ECRET <br />DAFSC <br />7. <br />073-44-5168 <br />Everett WA 98202 <br />CORPORATE LIMITS OF DUTYSTATION2851 <br />1cQS <br />I ART <br />CRR 9. AINDY•EXP+ <br />O.-PURPOSE OF YOUR AU TH•NO. <br />nil L� ANNUAL li) ( SCHOOL l2]) Ml SPECIAL APT 0RAPA) MAN -DAY TOUR MAN•PAY ID 5AMSX27AOO <br />I.REPOATthu uAIAIrr,N.'JHAIIs. (11 other cumorlt of umat, CV) 1. nosh-.() <br />ORDERED TO AO VON <br />CO" c0L 446AMS MCCHORD APB WA 98438-6004 <br />O""' 0,11U 1ci <br />�pAYi INCLYII(O TVL TIME <br />OATL'iF'h iw DO UNIT OF ATCH is THE COMOR EXEIICISI NO 66184E AL COURT YAPTIAL <br />YA 9843b-5000 <br />1 <br />IL RELEASE <br />/�,(�f•� CONVENINC AUTH OVERRCChord RFB <br />MAO INITIALS `LA/ ' CPU 850815 COI <br />la, TRAVEL DAYS AUTHORIZED IS. COMMUTE CON 16. VOC STAT 6YENT COT IT. PRIMARY DEPN <br />r'1Cdb YES IL NO ID YES NO <br />u YES'a O(11 AT TVL DAYS_- [_� <br />IS. VARIABLE TOUM STATEMENT <br />W BY PROPER AUTH• IF NOR REMAINS ON SPECIAL /SCHOOL TOUR 1RPA) IN EXCESS OF DAYS SHOWN. 111E ORDER NELD <br />SUB] TO APPR <br />NOT BE AMENDED IF NUMBER OF DAYS SHOWN IN BLOCK1O 15 LESS THAN SO AND DAYS SHOWN IS NOT EXCEEDED By AGO PERCENT OR <br />Ie0 <br />7 PAYS, VHICHEVER IS LESS. IN NO EVCMT WILL THESE ORDERS EXCEED A TOTAL OF n <br />pcllle n,eha) <br />19. TUG•LAT•IND CPS 20. TOUR-INO CPT SI. RAS CODE 22. AUTHORITY, COP AFR 2Me1 <br />Alc e <br />23. YBR•S TVL VOU AND COYPL ZrMT •fit• TOUR TO BE FILED WITHIN S WORKDAYS AFTER TOUT COYPL. ATCN CERTIFIED COPY OF <br />POV IS SPECIFICALLY AUTH, TRAVELER'S DEP <br />ORDER TO TVL VOU IF TOUR Is rXTCNDED OR TERMINATED. UNLESS USE OF <br />DAY BEFORE AND I DAY A/TER TOUR OT. TVA. AT OTHER TIMES AND DEVIATIONS AIR OIACCT •i VL ARE AT <br />IS LTD TO 1 <br />TRAVELER'S OfH RISK. UTILIZE OOVT OTRS IF AVAL. _ <br />ZS. TOTAL AT TRe (Hurd ul,a) USED THIS FY <br />Ze. TOTAL AT DAYS USED THIS FY <br />Turn in all promotional items, for example, gifts, bonus tickets, stc to the AFO. <br />21L REMARKSIAUU-SeOANI <br />diem payment is based on available government quarters and mess, contact <br />Since your per <br />to see if they are available. Member must pay TDY surcharge at <br />base billeting office <br />military facilities. <br />a. CHARGEABLE To ((T.61. 52) <br />575370- 505 6272 1'727.01 .02 .05 38010 <br />P A A <br />P.A 0 TR D.Rlbl RV r. ORDER 110. CPY i. DATE CPZ <br />i D1sTRnuTION D-7030 <br />D <br />1-MAW/MAP IF RT E YYAND <br />Si bIGNAT URE CLEMENT OF AUTNl NTICATIJO OFFICIAL (T.aI• ])) <br />SI. DESIGNATION AND LOCATION OF HEADQUARTERS CQS/01 a .h <br />DEPARTMENT OF THE AIR FORCE <br />00 446 ABS (AFRES) ( <br />EEO AA S T, USAFA (ART) <br />ReChord AFB, VA. 98438 -6004 <br />Chi R <br />STATEMENT OF TOUR OF OUT <br />NODE <br />]L <br />t <br />LOCATION <br />n <br />DATE <br />YONTN �., LOC <br />HOUR <br />1 <br />DATE <br />MONTH <br />TRAVELOF <br />10 <br />DEPART <br />ARRIVE <br />DEPART ARRIVE <br />I callly all have complied with &tern ortfry Net the lath An Just and two In All reFpecb, And IAsi / hne not revel ved pa]TnwIL 1 <br />pay from the Ooremme t of the <br />areho7 certify that If I was In nesipf of r �arlalm, a dlsabHlty, :oelPmsa/Ion, or nflraj(nfalner <br />a issue <br />I (roe�� n�Im Pf(ed to win le BAQeed <br />aldng Stairs, doa.•ted IntheAbe" order. My spouse (d1r0 (did not) draw dam BAQ.1t <br />I 4dge and <br />(am) (am Mot) m flying efatus, if this lour was extended order the variable four Provision, If war with my prior M0,1 a,naunf <br />DAT <br />M[MBCR'S SIGNATURE <br />CERTIFICATION <br />certify that the above member reported for drty of hours m And was released hum &JAY At—houn m--- <br />CERTIFYING OFFICIAL'S MAY[, GRAD[, AND TITLE <br />MIAATURE GAT[ <br />AFRES ]AM jj 931 REPLACES AI ME$ FORMS ON IT ESTI. SEP al• AND 175, AUG 83• WHICH ARM UNw Cc,c. vvclprSOL <br />