EFTA00129471¶
PD-794 (Rev. 2-7-00)¶
1. Classification¶
☐ (AC) Criminal Case ☐ (AD) Criminal OCDETF Case ☐ (AF) PCI Case ☐ (BC) Informant/CW ☐ (BD) Informant/CW Providing Drug Info.¶
☐ (CF) Asset ☐ (DC) Group II UCO ☐ (DD) OCDETF Group II ☐ (E) Group I ☐ (F) PCI UCO ☐ (G) AO PPS ☐ (GC) Air Operation ☐ (H) SSG ☐ (J) PCI Lookout¶
Draft Request¶
2. Date¶
3. Request for: ( ) Advance ( ) Expense¶
4. Social Security No:¶
5. Payee Name:¶
6. File No:¶
8. Amount¶
| Cat Item No | Description | Amount |
|---|---|---|
| 01 | ||
| 02 | ||
| 03 | ||
| 04 | ||
| 05 | ||
| 06 | ||
| 07 |
9. Total $¶
10. Justification:¶
Asset/Informant File No.: ___ Symbol No. Payment/Code Name: ___ Period Covered___ to__ One Time Non-symbol Source Payment: True Name: ___ DOB: ___ / ___ SSAN: ___ Date of Waiver: ___¶
11. Payment for reimbursable expense - forfeiture or drug related? ___ Yes ___ No¶
12. Requested by:¶
| Telephone No: |¶
14. Approval¶
| Date |
|---|
| Supervisor Initials: ___ |
| SAC / ASAC / AO / SAS Approval: ___ |
| Supply Technician Approval: ___ |
| Draft Approval Officer: ___ |
| Procurement Authorization: ___ No. |
15. Vendor No. | Group No. | Obligation No. |¶
18. Cost Center:¶
19. Squad/RA:¶
20. Follow-up Date:¶
21. Document No:¶
22. CONF / COMM__¶
23. Draft No:¶
24. Date:¶
25. Cashier:¶
26. Settlement of Advance: Prior month Advance Balance: $___¶
This Advance: $___ Less: Receipts: $___ Funds Returned and/or Cash on Hand: $___ Amount to Be Reimbursed: $___¶
27. Document No:¶
28. Draft No:¶
29. Date:¶
30. Cashier:¶
Classification: ___¶
Blue Copy - Administrative / Case File¶
Classified By: ___¶
Declassify on:¶
72-MM-113327-21¶
EFTA00129472¶
DRAFT REQUEST FORM INSTRUCTIONS¶
REQUESTING EMPLOYEE - Complete blocks 1 to 13 as follows:¶
1 - Enter Budget Category Classification to which expenses will be charged.¶
2 - Current date.¶
3 - Check the box to indicate if this request is for an advance of funds or for payment of an expense.¶
4 - Your Social Security Account Number.¶
5 - The name of the person or company that should appear on the check.¶
6 - The substantive file number, or the file number of the case benefitted by a payment to an informant, asset or cooperative witness. (If more than one case, see No. 10 below)¶
7 - Brief description of the type of expense to be paid.¶
8 - Amount requested for each type of expense.¶
9 - Total amount requested.¶
10 - Enter a brief justification for expense or advance requested. Indicate multiple cases benefitted by asset/information/CW payment if applicable. For Field Office Use Only: A justification electronic communication must be completed for informant/asset/CW expenses and placed in the applicable informant/asset/CW file, maintained in the field office.¶
11 - Check the proper answer to indicate if the requested expense is reimbursable as asset forfeiture related or as a payment for drug information.¶
12 - Your name.¶
13 - Your telephone number or extension.¶
APPROVAL:¶
14 - Each request should be reviewed by the employee’s direct supervisor, who should initial the form to indicate review. Confidential expenses must be approved by signature of an ASAC or above. Expense/Advance requests for the purchase of supplies or equipment must be approved by the Supply Technician prior to payment. Commercial expenses must be approved by signature of an AOSM or above prior to payment. The Draft Approval Officer may approve commercial expenses under $50.00. Indicate the name of the FBIHQ procurement officer and telephonic authorization number (T-number), if appropriate. All advances and expenses must be approved by the Draft Approval Officer, who will complete the following parts of this form:¶
APPROVAL OFFICER:¶
15 - Vendor Number and Vendor Group Number.¶
16 - Classify the expense using Catalog Number (CAT) and Item Number.¶
17 - Obligation number if an advance is issued.¶
18 - Your cost center.¶
19 - Squad/RA code, if applicable.¶
20 - Follow-up date for advance liquidation.¶
DRAFT CASHIER:¶
21 - Document Number assigned to this transaction.¶
22 - Check if this transaction is confidential (CONF) or commercial (COMM).¶
23 - Draft Number.¶
24 - Date issued.¶
25 - Cashier initials.¶
26 - Enter advance settlement information when receipt of transaction is entered. If a supplemental draft is issued, complete blocks 27 to 30.¶
26 - Enter advance settlement information when receipts are presented and the matching expense¶
27 - Document Number issued to this transaction.¶
28 - Draft Number.¶
29 - Date issued.¶
30 - Cashier initials.¶