ࡱ> WV a`\p jsanderson Ba==hKL,8X@"1Arial1Arial1Arial1Arial1Arial1Arial1Arial1Arial1Arial1Arial1Tahoma1Arial1Arial1xArial1xArial1 Arial1$Arial1Arial1QTahoma1QTahoma1Arial1QTahoma1QTahoma1 Arial1Arial"$"#,##0_);\("$"#,##0\)!"$"#,##0_);[Red]\("$"#,##0\)""$"#,##0.00_);\("$"#,##0.00\)'""$"#,##0.00_);[Red]\("$"#,##0.00\)7*2_("$"* #,##0_);_("$"* \(#,##0\);_("$"* "-"_);_(@_).))_(* #,##0_);_(* \(#,##0\);_(* "-"_);_(@_)?,:_("$"* #,##0.00_);_("$"* \(#,##0.00\);_("$"* "-"??_);_(@_)6+1_(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)0.0;;; mmm\-yyyy"Yes";"Yes";"No""True";"True";"False""On";"On";"Off" #,##0.0                + ) , *         +! A  ! !@@A  @A "@A #@A +  @A  @A  @@A  A   @A   A  @A  @ A   A   A   A  A   A  A    !@A  A "A " A !@@A  !@A  ! @A ! A  ! A  !A  ! 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Add sequential alpha character to adjustment claims.BLOCK 2.BLOCK 3.BLOCK 5. BLOCK 5A.2Enter date expense incurred (as shown on receipt). BLOCK 5B. BLOCK 5C. BLOCK 5D.0Check appropriate block to identify entry in 5B. BLOCK 5E. BLOCK 5F. BLOCK 5G. BLOCK 5H.LEnter the amount claimed for the entry in 5B and attach original receipt(s). BLOCK 5I. BLOCK 5J. BLOCK 5K. BLOCK 5L.BLOCK 6.BLOCK 7.Enter the total of column H.BLOCK 8.Enter the total of column I.BLOCK 9.Enter the total of column J. BLOCK 10.Enter the total of column K.CCheck the appropriate block for the type mission, one block only! C O THE CLAIMANT SHALL FORFEIT AND PAY TO THE UNITED STATES THE SUM OF FIVE TO TENITHOUSAND DOLLARS PLUS THREE TIMES THE AMOUNT OF DAMAGES SUSTAINED BY THE RHOURS FLOWN, AUTOMOTIVE FUEL/OIL USED, AND /OR OTHER MISCELLANEOUS COSTS INCURRED.If "Other," describe. Dual compensation is prohibited.and supporting documentation. The parties shall not claim costs on the CAPF 108 if expenses are being reimbursed from another source.4A. Mailing Address:BLOCKS 4A & 4B.# Check here if new address Enter the hourly aircraft minor maintenance rate for aircraft type entered in 5B. Reference current rates published in CAPR 173-3.SWERE FOR PARTICIPATION IN THE LISTED USAF AUTHORIZED MISSION AND ACCURATELY REFLECT B. TYPE ACFT MAKE/MODELD. ACFTE. ACFT/F. HOURS G. HOURLYH. ACFT I. FUEL ANDK. COMM/ OTHER COSTFLOWN/ NO. MILESEnter aircraft horsepower (hp).5Enter the type of aircraft or vehicle make and model.LEnter aircraft hours(hobbs) flown or number of miles driven for entry in 5B.9. OTHER 10. TOTAL_Enter the total of entries in blocks 6 through 9 OR total of column 5L (both should be equal)..Enter the sum of 5H through 5K as appropriate.11. CERTIFICATIONS. The parties signing in Blocks 11A and 11B are responsible for the accuracy and validity of the facts recited in the claims4Multiply the entry in 5F by 5G and enter the result.HP C. ACFT BFor instructions and help, place mouse pointer on triangles (red). ID/VEH ID ORXEnter appropriate mailing address, phone number and e-mail address for entry in block 3.Enter the aircraft registry number or, for corporate-owned vehicles (COV), the vehicle identification number or, for private-ownedEvehicles (POV), the vehicle license plate number corresponding to 5B.$4B. Phone Number and E-Mail Address: J. LODGING &PER DIEM COST CLAIMED 8. L & PD0REIMBURSEMENT FOR INDIVIDUAL CAP MEMBER EXPENSES4 FINE OF NOT MORE THAN TEN THOUSAND DOLLARS OR NOT ?MORE THAN FIVE YEARS IN PRISON OR BOTH. (SEE 18 U.S.C. 287) BLOCKS 11Read, sign and date.TEnter amounts claimed for lodging and per diem costs and attach original receipt(s).Enter amounts claimed for communications cost, aircraft oxygen service, authorized TDY expenses, etc., and attach original receipt(s).mCheck the appropriate block to identify if this is a partial or the final claim for the mission (block 1). LNOTE: A separate line entry must be made for each aircraft/vehicle unitized. All pilots flying on USAF authorized reimbursable missions MUST SUBMIT appropriate documentation to the wing showing aircraft flown, ownership, and } flying time even if no individual claim for reimbursement is made. This information is required for statistical purposes. This documentation and appropriate receipts must be submitted to the wing not later than 30 days after the close of the mission. Wings must prepare a consolidated mission CAPF 108 through WMIRS to the National Operations Center not later than 60 days after the close of the mission.73. Claimant (Region/Wing, Grade, Full Name and CAPID):-Enter region/wing, grade, full name and CAPIDLNOT TO BE USED BY REGION OR WING TO SUBMIT EXPENSES TO NATIONAL HEADQUARTERSERegion/Wing refer to Web Mission Information Reporting System (WMIRS)!CAP FORM 108, FEB 07 Reverse,CAP MEMBER: I CERTIFY THAT THE AMOUNTS PAID CAP FORM 108, FEB 07. PREVIOUS EDITIONS WILL NOT BE USED. THIS FORM CANNOT BE MODIFIED. 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