voucher for professional services · 2012. 11. 19. · t2e-26, . crrv _ rockvile istate zip code |...

-

NRC FORM 148(6-2002)NRCUO 10.6

U.S. NUCLEAR REGULATORY C ISSION

VOUCHER FOR PROFESSIONAL SERVICES

UNIT (OCFO use only)

-

INSTRUCTIONS

T7hs form shall be completed by all NRC consultants for claiming compensation for official authorized personnel services.A signed original and two copies shall be submitted to the NRC office authorizing the service.

TO: FROM: NAME OF CLAIMANT

U. S. Nuclear Regulatory Commission CGEORGE APOSTOLAKSATTENTION: NRC OFFICE AUITHOROZNG THIS SERVICE MEM MEMU WM

TANYA WINFREYACRS/ACNWT2E26-X7998

I

- inf&xmat whi li Fcobd was dendoAct exemp~ior eV

CITY

ROCKVILLE

STATE ZIP CODE

MD 20852

_ ,_

DESCRIPTION O LAIM E(All blocks must be completed)

NUMBER DATE

CONTRACT: AMOUNT CLAIMEDAT-(49-24)1901

FROM TOPERIOD COVERED DOLLARS CENTS(Dats)03/03/2004 03/27/2004

NUMBER OF DAYS PER DAY

SERVICES PERFORMED: 6255

(Itemiz on reverse) NUMBER OF HOURS PER HOUR 55

96 @$ 65.16

RETIRED ANNUITANT: F YES NO TOTAL AMOUNT 6,255 0LI CLAIMEDCERTIFICATION OFFICE OF THE CHIEF FINANCIAL OFFICER USE ONLY

I CERTIFY that the above account Is accurate and true Inall respects; that my statement of services correctly setsforth the services on official businesk; that the payment DIFFERENCEtherefor has not been received; end that no compensationfor any of the time shown above Is payable from or will be AWUNTclaimed from any other source of the Federal Government VERiFIEDor Its cost-reimbursable contractors. CORRECT

DG4TURE C DATE SIGNATURE DATE

'7APPPROVAL METHOD OF PAYMENT (Claimant -'Check one block)The Government Management Reform Actof 1994 requires

I CERTIFY that the above claim Is accurate; that the agencies to use Direct Deposit via Electronic Funds Transfer asabove services were officially requested and the method for making recurring Federal wage and salaryperformed; and that the expenses claimed areauthorized. LI DIRECT DEPOSIT FORM SF 1100A ATTACHEDSIGNATURE OfFICER DATE DIRECT DEPOSIT FORM PREVIOUSLY SUBMITTED

di . TREASURY CHECK (For one.tme payments only

NR FOR 418 (6-002 4r' .. I..,f~N I LI AC~ PAP ....... ._.T .a .e~ge ;sn . .c

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TANYA X. G. WINFREY - I

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PRPARATION. MEETING NAME8 RVL T. CATEGORY TTADATE NR OF WK T

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N4RC FORM 148(6-20MNRCMD 10A

U.S. NUCLEAR REGULATORY COPA....NSION UNIT (OCFO use only)

VOUCHER FOR PRO1ESSIONAL SERVICES

N. �

INSTRUCTIONSThis forrn shall be completed by all NRC consultants for claiming compensation for official authorized personnel servlces.A signed original and two copies shall be submitted to the NRC office audhorizing the servce.

-

TO: IFROM: NAME OF CLAiMANT 1U. S. Nuclear Regulatory Commission GEOR__ - -

ATTENTION: NRC OFFICE AUTHORIZNG THIS SERVICE I

TANYA WINREYACRS/ACNWT2E26-X7998

GEAPOSTOIAS

CnT

ROCKVILLE

STATE ZIP CODE

MD 20852_LO11

DESCRIPTION OF C(A0 blocks must be connpletedj

NUMBER DATE

CONTRACT: AMOUNT CLAIMEDAT-(49-24)-1901

FROM TOPERIOD COVERED DOLLUARS CENTS

(Dates) 01/11/2004 02/28/2004NUMBER OF DAYS PER DAY

SERVICES PERFORMED: . @

(4emiz on reverse) NUMBER OF HOURS PER HOUR 8,079 38

124 @ 65.16

RETIREDANNUITT YES 2 NOTOTAL AMOUNT 8,079 38RETI ED NNUI ANT [] Y s [ NOC L A IM E D .

CERTIFICATIONI CERTIFY that the above account Is accurate and true Inalt respects; that my statement of services correctly setshbrth the services on official business; that the paymenttherefor has not been received; and that no compensationfor any of the tfme shown above Is payable from or will becdlmed from any other source of the Federal Govemmentor is post-reimbursable contractors..

OFFICE OF THE CHIEF FINANCIAL OFFICER USE ONLY,

_ .

DIFFERENCE

AMOUNTVERIFIEDCORRECT

SIWALN tr.:qMMALISIGNATUE

V ' -" APPROVALI CERTIFY that the above claim Is accurate; that theabove services were officially requested endperformed; and that the expenses claimed areauthorizedI I

METHOD OF PAYMENT (Claimant - Check one block)The Government Management Reform Act of 1994 requiresagencies to use Direct Deposit via Electronic Funds Transfer asthe method for making recurring Federal wage and salary

[ DIRECT DEPOSIT FORM SF 11tWA ATTACHED] DIRECT DEPOSIT FORM PREVIOUSLY SUBMITTED

[ TREASURY CHECK (For one-time payments only)

PAPE The~tma deigne sung I~u.> PAPER Mk brm wn designed Using kh-aw

ACRS MEMBER'S COMPENSATION REPORT

TO: TANYA X. G. WiNFRtY

FROM: - g9)-oJS r-O LR A V4SI---- SIGNATUURE:

F AE ACTIVITY'COPE' UA U -PWORKEII IIIAL

-IaA

':IACRS MEMBER'S COMPENSATION FORM Rev. 5/2002

ACRS MEMBER'S COMPENSATION REPORT

TANYA X. G. WINFREY-

FROM: A l ai I . r a F ( i S$IGNATURRE: ~ ~

iNote: For Activity Codes, see Meverse s1 - ;-

--DXTE -ACTIVITY.CODEF'- NATURE OF WORK,e'g'..' . ,:: . . . ., IO. M ETING _AME, TRAVEL, E C J. TOTA L

"CILL"' r- ; ,~'~ h j; ' ' ,,,'' 0 { *.~ HOURS.J=L ____

. 5 4 4 . - .__r

. _;. , ................. 4 ...- . ,i

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P:IACRS MEMBER'S COMPENSATION FORM Rev. 6t2002

- - - a |-U

NRC FORM 148(6.2002)

I NR~CMD 10.6U.S. NUCLEAR REGULATORY COMMISSION UNIT (OCFO use only)


INSTRUCTIONSThis form shall be completed by all NRC consultants for claiming compensation for official authorized personnel services.A signed original and two copies shall be submitted to the NRC office authorizing the service. I

1*TO:

Tj- 1Q Wm1I'larvRponilgtnryI ronmniknin

FROM: NAME OF CLAIMANT

GEORG(E APnRTATA.AkTS -- -- . - --- MD ------ , I -- limb

ATTENTION: NRC OFFICE AUTHORIZING THIS SERViCE

TANYA WINFREYACRS/ACNWT2E26-X7998

. .rI

CIY STATE ZP CODE

IMID I- 20852IROCKVILLE

DESCRIPTI L AJ ,(All blocks must be completed)

NUMBER DATE

CONTRACT: AMOUNT CLAIMEDAT-(49-24)-1901 _

FROM TOPERIOD COVERED DOLLARS CENTS(Detes) 11/02/2003 11/24/2003

NUIMBER OF DAYS PER DAY

SERVICES PERFORMED: @ 5

(Itemize on myerse) NUMBER OF HOURS PER HOUR 5,650 26

88 @ S64.21

RETIRED ANNUITANT: F YES 2 NO TOTAL AMOUNT 5,650 26CLAIMED

CERTIFICATIONI CERTIFY that the above account Is accurate and true Inall respects; that my statement of services correctly setsforth the services on official business; that the paymenttherefor has not been receved; and that no compensationfor any of the time shown above Is payable from or wig beclaimed from any other source of the Federal Govemmentor is cost-telmbursable contractors.

OFFICE OF THE CHIEF FINANCIAL OFFICER USE ONLY

DIFFERENCE

AMOUNTVERIFIEDCORRECT.

SIGNATURE .CLAIMANT DATE SIGNATURE DATE

APPROVAL METHOD OF PAYMENT (Claimant - Check one block)E t t ve ci s a ta -. The Government Management Reform Act of 1994 requires--- --CERTIFY that the above cla ims E te; that th agencies to use Direct Deposit via Electronic Funds Transfer as

above services were officially requested and the method for making recurring Federal wage and salaryperformed; and that the expenses claimed areauthorized. DIRECT DEPOSIT FORM SF 1199A ATTACHED

SIGMA RE -PROIG OP C DATE / DIRECT DEPOSIT FORM PREWOUSLY SUSMTED

~ dl, 1 TREASURY CHECK (For on eme payments o y* F. .,

I

NRC FORM 149 (9-2=) i~-4-5-•2;/,~RINTED ON ROYCLED PAPER. TM II= was degWW LWng Wc;W

n IIW r ii1'Qi I III r 'ngMojeniger '03

TANYA X. G. WI NFREY

TOM: ___raboaeois

TE: See ravera for Labor Catagorleal. ..

SIGNATURE:

. 4) A

DATE ~~NATURE OFWOK.JAO- ,.(PRrPARATIN A¶EEtIwGNM.TRVLEc ATGROA

PqD~

.........

[SEE REVERSE SIDE FOR LABOR CATEGORIESJ tomu

NRC FORM 148(6-2002)NRCMD 106

.rU.S. NUCLEAR REGULATORY Ct .SSION

DNAL SERVICES

UNIT (OCFO use only)

. >6

for \VOUCHER FOR PROFESSII

_

INSTRUCTIONSThis form shall be completed by all NRC consultants for claiming compensation for official authorized personnel services.A signed original and two copies shal be submitted to the NRC office authorizng the service.

I

I.TO:

U. S. Nuclear Regulatory Comnission

FROM: NAME OF CLAIMANT

George Apostolakis__ _ _ _ _ _ _ _ ~ - -

ATrENTION: NRC OFFICE AUTHORIZING THIS SERVICE

Tanya WinfreyACRS/ACNWT2E-26

, ._

crrv

Rockvile

ISTATE ZIP CODE

| D 20852I I_

DESCRIPTION OF CLAIM(All blocks must be completed)

INUMBER DATE


FROM TOPERIOD COVERED DOLLARS(Dates) 12/04/2003 12/04/2003


SERVICES PERFORMED: e $

(Itemize on reverse) NUMBER OF HOURS PER HOUR 516 33

8 @ 642{0

r TOTAL AMOUNTRETIRED ANNUITANT: L 4 CLAIMED 516 33

CERTIFICATION OFFICE OF THE CHIEF FINANCIAL OFFICER USE ONLYI CERTIFY that the above account Is accurate and true Inaft respects; that my statement of services correctly setsforth the services on official business; that the payment DIFFERENCEtherefor has not been received; and that no compensationfor any of the time shown above Is payable from or will be MUNTclaimed from any other source of the Federal Govemment VERIFIEDor Its cost-reimbursable contractors. CORRECTSIGNATURE - CLAIMANT DATE SIGNATURE DATE

APPROVAL METHOD OF PAYMENT (Claimant - Check one block)The Government Management Reform Act of 1994 requires

I CERTIFY that the above claim Is accurate; that the agencies to use Direct Deposit via Electronic Funds Transfer asabove services were officially requested and the method for making recurring Federal wage and salaryperformed; and that the expenses claimed areauthorized . DIRECT DEPOSIT FORM SF 1199A ATTACHED

SIGNATURE - APPROVING OFFICER DATE DIRECT DEPOSIT FORM PREVIOUSLY SUBMITTED

TREASURY CHECK (For one-time payments only)

vR OR 4 (-202 P.NE .N ._.CLE PE . _w~a .aigh usn INRC FORM 148 a t002 PRINTED ON RECYCLED PAPER Ws fcwm was dwjWwd UsIre InFwn-

SERVICES PERFORMED.

RATE OF COMPENSATION PLACE(S) WORK PERFORMEDPER DAY PER HOUR

$ 51633 $ 64.20

TIME SERVICES PERFORMED (indicate a.m. orp.m.) iDATE FROM a.a. TOTA L H

a__ __ __ _ _ __ _ _ _ _ pm. HOURS_ __

12/0412003 8:00 am 5:00 pm 8.00 S00077

F _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ____ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

_ = =-

PRIVACY ACT STATEMENTPursuant lo US.C. 552a(e)(3), enacted into law by section 3 of the Privacy Act of 1974 (PublIc Law 93-579). the following statement Is furnished toIndividuals who supply hIformation to the Nuclear Regulatory Commission (NRC) on NRC Form 148. This Information Is maintained In a system ofrecords designated as NRC-21 and described at 65 Federal Register56429 (September 18, 2000); or the most recent Federal Register publication ofthe Nuclear Regulatory Commissions Flepublication of Systems of Records Nodces that Is available at the NRC Pubflc Document Room, I1555Rockville Pike, Rockilfle, MD, or located In the NRC. Agencywide Document Access and Management System (ADAMS).

1. AUTHORITY: Pub. L. 104-193, Personal Responsibility and Work Opportunity Reconciliation Act of 1966; 5 U.S.C. 6334 (1996); 31 U.S.C. 716.1104, 1108, 1114,3325,3511, 3512,3701,3711, 3717,3718 (1996-2000); Executive Order 9397, November 22, 1943.

2. PRINCIPAL PURPOSE(S): To claim compensation for official authorized personnel services rendered by government consultants.

3. ROUTINE USES: Information on this form Is used for transmittal to the U.S. Treasury for payment It may also be disclosed to the IRS, State andlocal taxing authorities, Social Security Adrninistration, labor unions, Insurance carriers, OPM, or charitable Institutions concerning any authorizedwithholdings or deductions. Information may be disclosed to an appropriate Federal. State, local, or Foreign agency In the event the InfornationIndicates a violation or potential violation of law and In the course of an administrative orJudicial proceeding. In addition, this Information may betransferred to an appropriate Federal, State, ocal, and Foreign agency to the extent relevant and necessary for an NRC decision about you or tothe extent relevant and necessary for that agency's decision about you. Information from this form may also be disclosed, hI the course of discoveryunder a protective order Issued by a court of competent jurisdiction, and In presenting evidence, to a Congressional office to respond to their Inquirymade at your request, or to NRC-paid experts, consultants, and others under contract with the NRC, on a need-to-know basis.

4. WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECT ON INDIVIDUAL OF NOT PROVIDING INFORMATION: It Isvoluntary that you fumish the requested Information; however, failure to supply the information may result In the denial of your claim forcompensation. The social security number (SSN) Is used to accurately maintain an Individual's records by confirming their Identity.

5. SYSTEM MANAGER AND ADDRESS: Chief, Payroll and Labor Reporting Branch, Division of Accounting and Finance, Office of the ChiefFinancial Officer, U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001.

'3 - - !NRC FORM 148(6-2002)NRCAD 10.8

-U.S. NUCLEAR REGULATORY Ct SSION UNIT (OCFO use only)


-Mi

INSTRUCTIONS

This form shall be completed by all NRC consultants for claiming compensation for official authorized personnel services.A signed original and two copies shall be submitted to the NRC office authorizing the service.


U. S. Nuclear Regulatory Commission George Apostolakis

ATTENTION: NRC OFFICE AUTHORIZING THIS SERVICE -.


CITY STATE |IP CODE

Rockville MD 20852

DESCRIPTION OF CLAIM(AO blocks must be completed)

NUMEER DATE


FROM TO.PERIOD COVERED DOLLARS CENTS(Dates) 12/0112003 12/01/2003


SERVICES PERFORMED: a $

(Itemize on reverse) NUMBER OF HOURS PER HOUR 516 338 $ 64.20

RETIRED ANNUTOTALAMOUNT 516 33CLAIMED

I

CERTIFICATIONI CERTIFY that the above account Is accurate and true Inall respects; that my statement of services correctly setsforth the services on officlal business; that the paymenttherefor has not been received; and that no compensationfor any of the time shown above Is payable from or will beclaimed from any other source of the Federal Governmentor its cost-reimbursable contractors.

OFFICE OF THE CHIEF FINANCIAL OFFICER USE ONLYIDIFFERENCEJ

AMOUNTVERIFIED

CORRECT

SIGNATURE - CLAIMANT DATE SIGNATURE

APPROVAL

I CERTIFY that the above claim Is accurate; that theabove services were officially requested andperformed; and that the expenses claimed areauthorized.

METHOD OF PAYMENT (Claimant - Check one block)The Government Management Reform Act of 1994 requiresagencies to use Direct Deposit via Electronic Funds Transfer asthe method for making recurring Federal wage and salary

R DIRECT DEPOSIT FORM SF1 199A ATTACHEDD DIRECT DEPOSIT FORM PREVIOUSLY SUBMITTEDD TREASURY CHECK (For one-tme payments only)

SIGNATURE -APPROVING OFFICER DATE

NRC FOAM 148 (8.2002) PRINTED ON RECYCLED PAPER IWs loan was designed using k�Fornu

NRC FORM 148 by202 PRINTED ON RECYCLED PAPFER Ws Iwm was designed WM InFam

-

SERVICES PERFORMED


$ 516.33 $ 64.20

TIME SERVICES PERFORMED (indicate a.m. orp.m.) ;DATE FROM a.m. TO a.m. TOTAL

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ p~m.p.m . H O U R S_ _ _ _ _ _ _ _ _ _ _ _ _ _

12101l2003 8:00 am 5:00 pm 8.00 S00077

= - = - ==

- PRIVACY ACT STATEMENTPursuant to 5 U.S.C. 552a(se)(3). enacted into law by section 3 of the Privacy Act of 1974 (Public Law 93-579), the following statement is fumished toIndividuals who supply Informaton to the Nuclear Regulatory Commission (NRC) on NRC Form 148. This Information is maintained In a system ofrecords designated as NRC-21 and described at 65 Federal Reglster56429 (September 18, 2000); or the most recent Federal Registerpublication ofthe Nudear Regulatory Commrission' Republlcatlon of Systems of Records Noticest that Is available at the NRC Public Document-Bloom, 11555Rockville Pike, Rockville, MD, or located In the NRC's Agencywide Document Access and Management System (ADAMS).

1. AUTHORITY: Pub. L. 104-193, Personal Responsibility and Work Opportunity Recondiliation Act of 1966; 5 U.S.C. 6334 (1998); 31 U.S.C. 71B,1104, 1108, 1114,3325,3511,3512,3701,3711,3717. 3718 (1996-2000); Executive Order 9397, November 22, 1943.


3. ROUTINE USES: Information on this form Is used for transmittal to the U.S. Treasury for paymient It may also be disclosed to the IRS, State andlocal taxing authorities, Social Security Administration, labor unions, Insurance carriers, OPM, or charitable Institutions concerning any authorizedwithholdings or deductions. Information may be disclosed to an appropriate Federal, State, local, or Foreign agency In the event the Informationindicates a violation or potential violation of law and In the course of an admnintstrative or Judicial proceeding. In addition, this information may betransferred to an appropriate Federal, State, local, and Foreign agency to the extent relevant and necessary for an NRC decision about you or tothe extent relevant and necessary for that agency's decision about you. Infonnation from this form may also be disclosed, In the course of discoveryunder a protective order Issued by a court of competent JurisdIction, and in presenting evidence, to a Congressional office to respond to their Inquirymade at your request or to NRC-pald experts, consultants, and others under contract with the NRC, on a needto-know basis.

4. WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECT ON INDMDUAL OF NOT PROVIDING INFORMATION: It isvoluntary that you furnish the requested Information; however, failure to supply the Information may result In the denial of your claim forcompensation. The social security number (SSN) Is used to accurately maintain an Individual's records by confirming their Identity.


. .A - I I i

(8-2002)NRCMD 10.6

W.Q. flU.,L6rfl "A.4At&bM I %06 a -- ' .. - .. . I - - . -


I

INSTRUCTIONSThis form shall be completed by all NRC consultants for claiming compensation for official authorized personnel services.A signed original and two copies shall be submitted to the NRC office authorizing the senrice.


U. S. Nuclear Regulatory Commission George ApostolaldsATTENTION: NRC OFFICE AUTHORIZING THIS SERVICE

Tanya WinfreyACRSIACNWT2E-26

CITY STATE ZIP CODE

Rockville MD 20852


NUMBER DATE

CONTRACT: AMOUNT CLAIMEDAT-(49-24)-1901 _

FROM TOPERIOD COVERED DOLLARS CENTS(Daes) 1213/2003 12/13/2003


SERVICES PERFORMED: e

(temie on reverse) NUMBER OF HOURS PER HOUR 516 33

8 @5 64.20

RETIRED ANNUITANT: TOTAL AMOUNT 51__33C _ CLAIMED 516 33

CERTIFICATION OFFICE OF THE CHIEF FINANCIAL OFFICER USE ONLYI CERTIFY that the above account Is accurate and true Inalt respects; that my statement of services correctly setsforth the services on official business; that the payment DIFFERENCEtherefor has not been received; and that no compensationfor any of the time shown above Is payable from or will be AMOUNT_claimed from any other source of the Federal Govemment VERIFIEDor Its cost-reimbursable contractors. CORRECTSIGNATURE - CLAIMANT DATE SIGNATURE DATE

APPROVAL METHOD OF PAYMENT (Claimant - Check one block)The Govemment Management Reform Act of 1594 requires

I CERTIFY that the above claim Is accurate; that the agencies to use Direct Deposit via Electronic Funds Transfer asabove services were offlcially requested and the method for making recurring Federal wage and salaryperformed; and that the expenses claimed areauthorized LI DIRECT DEPOSIT FORM SF IIBA ATFACHEDSIGNATURE - APPROVING OFFICER DATE f DIRECT DEPOSIT FORM PREVIOUSLY SUBMITTED

D TREASURY CHECK (For one-time payments only)

C6

NRC FORM 14 (62002 PRNTED ON RECYCLED PAPER TNs form was dWV*d Using InFmm

1121r.KV11L#r.b rthrunmr-IJ


$ 516.33 $ 6420

TIME SERVICES PERFORMED (indicate a.m. orp.m.) -DATE FROM pl Tm. TOTAL | H 8 URS

_ _ _ _ p.m. M__ _ .mH O R1213/2003 8:00 a_ 5:00 pm 8.00 S00022

=-

PRIVACY ACT STATEMENTPursuant to 5 U.S.C. 552a(e)(3). enacted Into law by sectIon 3 of the Privacy Act of 1974 (Public Law 93-579), the following statement Is furnished toIndividuals who supply Information to the Nuclear Regulatory Commission (NRC) on NRC Form 148. This Information Is maintained In a system ofrecords designated as NRC-21 and described at 65 Federal Register56429 (September 18, 2000); or the most recent Federal Registerpublication ofthe Nuclear Regulatory Commission's "Republication of Systems of Records Notices" that Is available at the NRC Public Document Room, 11555Rockvllle Pike, Rockville, MD, or located In the NRCs Ageneywide Document Access and Management System (ADAMS).

1. AUTH ORITY: Pub.L 104-193, Personal Responsibility and WoeicOpportunty Roeondilaiaon Act of 1966; 5U.S.0.6334 (1996); 31 U.S.C. 716,1104, 1108, 1114,3325,3511,3512,3701,3711,3717.3718(1896-2000); ExecutveOrder9397, November22, 1943.


3. ROUTINE USES: Information on this form Is used for transmittal to the U.S. Treasury for payment. It may also be disclosed to the IRS, State andlocal taxing authorities, Social Security AdministratIon, labor unions, Insurance carriers, OPM, or charitable Institutions conceming any authorizedwithholdings or deductions. Information may be disclosed to an appropriate Federal, State, local, or Foreign agency In the event the InformationIndicates a violation or potential violation of law and in the course of an administrative or Judicial proceeding. In addition, this Information may betransferred to an appropriate Federal. State, local, and Foreign agency to the extent relevant and necessary for an NRC decision about you or bthe extent relevant and necessary for that agency's decision about you. Information from this form ftry also be disclosed, In the course of discoveryunder a protective order Issued by a court of competent Jurisdiction, and In presenting evidence, to a Congressional office to respond to their Inquirymade at your request, or to NRC-pald experts, consultants, and others under contract with the NRC, on a need-to-know basis.

4. WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECT ON INDIVIDUAL OF NOT PROVIDING INFORMATION: It isvoluntary that you furnish the requested Information; however, failure to supply the Information may result In the denial of your claim forcompensation. The social security number (SSN) Is used to accurately maintain an Individual's records by confirming their Identity.


IRC FORM 148:6-2002)NACMD 10.6

1U.W.r4UL0LCAnnr-%XWL.r%1 %Is.. - .--. .


INSTRUCTIONS

This form shall be completed by all NRC consultants for claiming compensation for officlalauthorizedpersonnel servlces.A signed original and two copies shall be submitted to the NRC office authorizing the service.

TO: FROM NAME OF CLAIMANT

U. S. Nuclear Regulatory Commission George ApostolakisATTENTION: NRC OFFICE AUTHORIZING THIS SERVICE


CITY STATE. ZIP CODE

Rokvlle JTMD 20852


NUMBER DATE

CONTRACT: AMOUNT CLAJMED

AT-(49-24)-1901FROM TO

PERIOD COVERED DOLLARS CENTS(Dates) 12/29/2003 12/29/2003


SERVICES PERFORMED: a $

(Itemize on rvs) NUMBER OF HOURS PER HOUR 516 33

8 e 64.20

RETIRED ANNUANT: E TOTALAMOUNT 516 33

CERTIFICATION OFFICE OF THE CHIEF FINANCIAL OFFICER USE ONLYI CERTIFY that the above account is accurate and true Inall respects; that my statement of services correctly setsforth the services on official business; that the payment PERENCEtherefor has not been received; and that no compensation _ __for any of the time shown above Is payable from or will be AMOUNTclaimed from any other source of the Federal Government VERRFIEDor its cost-reimbursable contractors. CORRECTSIGNATURE - CLAiMANT DATE SIGNATURE DATE

APPROVAL METHOD OF PAYMENT (Claimant- Check one block)I CETIF tha th aboe caimIs acurte; hatthe The Government Management Reform Act of 1994 requires

I CERTIFY that the above claim Is accurate, that theagencies to use Direct Deposit via Electronic Funds Transfer asabove services were officially requested and the method for making recurring Federal wage and salaryperformed; and that the expenses claimed areauthorized. DIRECT DEPOSIT FORM SF 1199A ATTACHED

SIGNATURE - APPROVING OFFICER, DATE D DIRECT DEPOSIT FORM PREVIOUSLY SUBMITTEDD TREASURY CHECK (For one-Ume payments only)

r.ZX'7

NRC FOM148 (5-20) PRINTE ON RECLE PAPE This form was designed using kfornx

- rnvii.co rcnrvnmwu


$ 516.33 $ 64.20

TIME SERVICES PERFORMED (indcate a.m. orp.m.)DATE FRM am O am. TOTAL

a,___ _ __ _ .M. __ _ __ A. HOURS PR12/29n2003 8:00 am 5:00 pm 8.00 S00102

= =

PRIVACY ACT STATEMENTPursuant to 5 U.S.C. 552a(e)(3), enacted Into law by section 3 of the Privacy Act of 1974 (Public Law 93-579), the following statement Is furnished toIndividuals who supply Information to the Nuclear Regulatory Commission (NRC) on NRC Form 148. This Information Is maintained In a system ofrecords designated as NRC-21 and described at 65 Federal Reglster56429 (September 18, 2000); or the most recent Federal Regsterpublicadon ofthe Nuclear Regulatory Comrmission's Repubflcatlon of Systems of Records Noticee that Is available at the NRC Public Document Room, 116558Rockville Pike, Rockville, MD, or located In the NRCs Agencywide Document Access and Management System (ADAMS).

1. AUTHORITY: Pub. L 104-193, Personal Responsibillty and Work Opportunity Reconciliation Act of 1966; 6 U.S.C. 6334 (1996), 31 U.S.C. 716,1104,1108,1114,3325,3511,3512,3701,3711,3717,3718 (1996-2000); Executive Order 9397, November22, 1943.


3. ROUTINE USES: Information on this form Is used for transmittal to the U.S. Treasury for payment. It may also be disclosed to the IRS, State andcal taxing authorities, Social Security Administration, labor unions, Insurance carriers, OPM, or charitable Institutions concerning any authorized

withholdings or deductions. Information may be disclosed to an appropriate Federal, State, local, or Foreign agency In the event the InformationIndicates a violation or potenial violation of law and In the course of an adrinistratve or Judidal proceeding. In additon, this Information may betransferred to an appropriate Federal, State, local, and Foreign agency to the extent relevant and necessary for an NRC decision about you or tothe extent relevant and necessary for that agency's decision about you. Information from this form may also be disclosed, In the course of discoveryunder a protective order Issued by a court of competent Jurisdiction, and In presenting evidence, to a Congressional office to respond to their Inquirymade at your request, or to NRC-paid experts, consultants, and others under contract with the NRC, on a need-to-know basis.

4. WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECT ON INDIVIDUAL OF NOT PROVIDING INFORMATION: it Isvoluntary that you furnish the requested Information; however, failure to supply the Information may result In the dental of your claim forcompensation. The social security number (SSN) Is used to accurately maintain an Individuals records by confirming their Identity.

5. SYSTEM MANAGER AND ADDRESS: Chief, Payroll and Labor Reporting Branch, DlvisIon of Accounting and Finance, Office of the ChiefFinancial Officer, U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001.

,16"Aoejt 'r-3;TANYA X. G. WINFREY

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(6-2002)NRCMD.10J1

VOUCHER FOR PROFESSIONAL SERVICES IINSTRUCTIONS

This form shal be completed by all NRC consultants for claiming compensation for official authorized personnel services.A signed original and two copies shall be submitted to the NRC office authorizing the service.

TO, FROM: NAMEOFCLAIMANT

U. S. Nuclear Regulatory Commission GEORGE APOSTOLAKIS

ATTENTION: NRC OFFICE AUTHORIZNG THIS SERY1CE --- Maee

TANYANVINFREYACRS/ACNWT2E26-X7998

STATE ZIP CODE

ROCKVILLE MD 20852

DESCRIP OF CLAIM(All blocks must be completed)

r,

NUMBER DATECONTRACT: AMOUNT CLAIMED

AT-(49-24)-1901FROM TO

PERIOD COVERED DOLLARS CENTS(Dates) 10/0112003 10/31/2003


SERVICES PERFORMED: a S

(Itemize on revese) NUM8ER OF HOURS PER HOUR 4,622 94

72 @$ 6421

RETIRED ANNUITANT: Fl YES F- NO TOTAL AMOUNT 4,622 94CLAIMED

CERTIFICATION OFFICE OF THE CHIEF FINANCIAL OFFICER USE ONLYI CERrIFY that the above account Is accurate and true Inafl respects; that my statement of services correcly setsforth the services on official business; that the payment DIFFERENCEtherefor has not been received; and that no compensationfor any of the tme shown above Is payable from or will beclaimed from any other source of the Federal Government VERIFIEDor its cost-reimbursable contractors. CORRECTSIGNATURE- CLAIMANT DATE SIGNATURE DATE

APPROVAL METHOD OF PAYMENT (Claimant - Check one block)The Government Management Reform Act of 1994 requires

I CERI7FY that the above claim Is accurate; that the agencies to use Direct Deposit via Electronic Funds Transfer asabove services were officially requested and the method for making recurring Federal wage and salaryperformed; and that the expenses claimed areauthorIzed. D DIRECT OEPOSIT FORM SF lIS19A ATTACHEDSIGNATURE - APPROVINGtICER |DATE D DIRECT DEPOSIT FORM PREVIOUSLY SUEMITTED

TREASURY CHECK (For one-fme payments only)

RCPfA(66.,02 (. ,1 / , .RNT .* _EYLDPPRTi ~ a eindin r~mNRC FORM W (&20021 0 1,4 / / PFUNTED ON RECYCLED PAM This forams designed using kiftms

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TANYA X. G. WINFREY

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HOURSDATE : NATURE OF WORK LABOR

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voucher for professional services · 2012. 11. 19. · t2e-26, . crrv _ rockvile istate zip code |...

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