+----------------------------+-----------------------------------------+
| **CAP                      | 1\. MISSION NUMBER: **     ** START     |
| PAYMENT/REIMBURSEMENT      | DATE: **     ** STOP DATE: **     **    |
| DOCUMENT FOR**             |                                         |
|                            |                                         |
| **AVIATIO                  |                                         |
| N/AUTOMOTIVE/MISCELLANEOUS |                                         |
| EXPENSES**                 |                                         |
+----------------------------+-----------------------------------------+

+-----------------------+---------------------+-----------------------+
| 2\. TYPE MISSION:     | 3\. CLAIMANT        | 4\. MAILING           |
|                       | (Wing/Member)       | ADDRESS/PHONE NUMBER  |
| SAR/DR EVAL/TRNG      |                     |                       |
| CUSTOMS               | **     **           | **     **             |
|                       |                     |                       |
| DEA/USFS FAA OTHER    |                     | **     **             |
+-----------------------+---------------------+-----------------------+
| 5\. INVOICE *(Print   |                     |                       |
| or Type) (**Please    |                     |                       |
| read the instructions |                     |                       |
| on the reverse**)*    |                     |                       |
| FINAL PARTIAL         |                     |                       |
| \$[     ]{.underline} |                     |                       |
| ESTIMATE OUTSTANDING  |                     |                       |
+-----------------------+---------------------+-----------------------+

<table style="width:100%;">
<colgroup>
<col style="width: 8%" />
<col style="width: 7%" />
<col style="width: 7%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 6%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 7%" />
<col style="width: 10%" />
</colgroup>
<tbody>
<tr class="odd">
<td>A. DATE</td>
<td>B. TYPE AIRCRAFT OR VEHICLE</td>
<td>C. AIRCRAFT ID/VEHICLE LICENSE</td>
<td colspan="2"><p>D. AIRCRAFT/ VEHICLE OWNER</p>
<p>CORP MBR</p></td>
<td>E. HOURS FLOWN</td>
<td><p>F. HOURLY RATE</p>
<p>A/C MINOR MAINTENANCE</p></td>
<td>G. AIRCRAFT COST CLAIMED</td>
<td>H. FUEL AND OIL COST CLAIMED</td>
<td>I. COMM COSTS CLAIMED</td>
<td><p>J. ADMIN</p>
<p>(IF APPLICABLE)</p></td>
<td>K. OTHER COST CLAIMED</td>
<td>L. SUB –TOTAL CLAIMED</td>
</tr>
<tr class="even">
<td>     </td>
<td>     </td>
<td>     </td>
<td></td>
<td></td>
<td>    </td>
<td>     </td>
<td>$ 0.00</td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>$ 0.00</td>
</tr>
<tr class="odd">
<td>     </td>
<td>     </td>
<td>     </td>
<td></td>
<td></td>
<td>    </td>
<td>     </td>
<td>$ 0.00</td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>$ 0.00</td>
</tr>
<tr class="even">
<td>     </td>
<td>     </td>
<td>     </td>
<td></td>
<td></td>
<td>    </td>
<td>     </td>
<td>$ 0.00</td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>$ 0.00</td>
</tr>
<tr class="odd">
<td>     </td>
<td>     </td>
<td>     </td>
<td></td>
<td></td>
<td>    </td>
<td>     </td>
<td>$ 0.00</td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>$ 0.00</td>
</tr>
<tr class="even">
<td>     </td>
<td>     </td>
<td>     </td>
<td></td>
<td></td>
<td>    </td>
<td>     </td>
<td>$ 0.00</td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>$ 0.00</td>
</tr>
<tr class="odd">
<td>     </td>
<td>     </td>
<td>     </td>
<td></td>
<td></td>
<td>    </td>
<td>     </td>
<td>$ 0.00</td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>$ 0.00</td>
</tr>
<tr class="even">
<td>     </td>
<td>     </td>
<td>     </td>
<td></td>
<td></td>
<td>    </td>
<td>     </td>
<td>$ 0.00</td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>$ 0.00</td>
</tr>
<tr class="odd">
<td>     </td>
<td>     </td>
<td>     </td>
<td></td>
<td></td>
<td>    </td>
<td>     </td>
<td>$ 0.00</td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>$ 0.00</td>
</tr>
<tr class="even">
<td>     </td>
<td>     </td>
<td>     </td>
<td></td>
<td></td>
<td>    </td>
<td>     </td>
<td>$ 0.00</td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>     </td>
<td>$ 0.00</td>
</tr>
<tr class="odd">
<td colspan="7"><p>TOTAL CLAIMED BY CATEGORY</p>
<p><strong>     </strong></p></td>
<td><p>6.ACFT COST</p>
<p><strong>$ 0.00</strong></p></td>
<td><p>7. FUEL / OIL</p>
<p><strong>$ 0.00</strong></p></td>
<td><p>8. COMM</p>
<p><strong>$ 0.00</strong></p></td>
<td><p>9. ADMIN</p>
<p><strong>$ 0.00</strong></p></td>
<td><p>10. OTHER</p>
<p><strong>$ 0.00</strong></p></td>
<td><p>11. GRAND TOTAL</p>
<p><strong>$ 0.00</strong></p></td>
</tr>
</tbody>
</table>

+-------------------------------------+---------------+---------------+
| 12\. CERTIFICATIONS                 |               |               |
+-------------------------------------+---------------+---------------+
| A. CAP MEMBER:                      |               | ^SIGNATUR     |
|                                     |               | E\ AND\ DATE^ |
| I CERTIFY THAT THE AMOUNTS CLAIMED  |               | **     **     |
| WERE PAID FROM PERSONAL FUNDS FOR   |               |               |
| PARTICIPATION IN THE LISTED USAF    |               |               |
| AUTHORIZED MISSION AND ACCURATELY   |               |               |
| REFLECTS HOURS FLOWN, AUTOMOTIVE    |               |               |
| FUEL/OIL USED, AND/OR OTHER         |               |               |
| MISCELLANEOUS COST INCURRED.        |               |               |
+-------------------------------------+---------------+---------------+
| B. WING COMMANDER:                  |               | ^SIGNATUR     |
|                                     |               | E\ AND\ DATE^ |
| I CERTIFY THE ABOVE EXPENSES ARE A  |               |               |
| DIRECT RESULT OF                    |               |               |
| SUPPORT/PARTICIPATION IN THE ABOVE  |               |               |
| LISTED USAF AUTHORIZED MISSION.     |               |               |
+-------------------------------------+---------------+---------------+
| C. STATE DIRECTOR/DEPUTY STATE      |               | ^SIGNATUR     |
| DIRECTUSAF LIAISON OFFICE:          |               | E\ AND\ DATE^ |
|                                     |               |               |
| I CERTIFY THIS CLAIM IS TRUE AND    |               |               |
| PROPER FOR PAYMENT                  |               |               |
+-------------------------------------+---------------+---------------+
| D. CAP-USAF/GOVERNMENT OFFICIAL     | E. MORD       | ^SIGNATUR     |
| AUTHORIZED TO RECEIVE               | NUMBER        | E\ AND\ DATE^ |
| SUPPLIES/SERVICED-RECEIVED          |               |               |
|                                     |               |               |
| Printed Name, Title, Mailing        |               |               |
| Address, and Telephone Number       |               |               |
+-------------------------------------+---------------+---------------+

+-------------------------------------+--------------------------------+
| CIVIL PENALTY FOR PRESENTING        | CRIMINAL PENALTY FOR           |
| FRAUDULENT CLAIM:                   | PRESENTING FRAUDULENT CLAIM.   |
|                                     |                                |
| "THE CLAIMANT SHALL FORFEIT AND PAY | "FINE OF NOT MORE THAN TEN     |
| TO THE UNITED STATES THE SUM OF TWO | THOUSAND DOLLARS OR NOT MORE   |
| THOUSAND DOLLARS PLUS DOUBLE THE    | THAN FIVE YEARS IN PRISON OR   |
| AMOUNT OF DAMAGES SUSTAINED BY THE  | BOTH."                         |
| UNITED STATES."                     |                                |
|                                     | (SEE 18 U.S.C. 287.1001)       |
| (SEE 31 U.S.C. 3729) (APPLICABLE TO | (APPLICABLE TO ALL             |
| ALL SIGNATORIES)                    | SIGNATORIES)                   |
+-------------------------------------+--------------------------------+

**CAP FORM 108(EF), MAY 02** PREVIOUS EDITIONS WILL NOT BE USED AFTER 31
AUGUST 2002. **THIS FORM CANNOT BE MODIFIED.** OPR/ROUTING: FM

# INSTRUCTIONS FOR COMPLETING THE CAPF 108

**(Applicable to all personnel/squadrons submitting reimbursement /
payment claims)**

-   All pilots flying on USAF authorized reimbursable missions MUST
    SUBMIT a CAPF 108 to the wing showing aircraft flown, ownership, and
    flying time (blocks 5A-K) even if no individual claim for
    reimbursement is made. This information is required for statistical
    purposes.

-   Members must submit original CAPF 108 and appropriate receipts to
    the wing not later than 30 days after the close of the mission
    (60-day adjustment period).

-   Wings must prepare a consolidated mission CAPF 108 and include
    corporate aircraft expenses.

BLOCK 1. Enter mission number and mission inclusive dates. Add
sequential alpha character to adjustment claims.

BLOCK 2. Check the appropriate block for the type mission, one block
only! If "Other," describe in the block labeled "Total Claimed by
Category" below columns A-F.

BLOCK 3. Enter member name (or wing name on the consolidated 108).

BLOCK 4. Enter appropriate mailing address/phone number for entry in
block 3.

BLOCK 5. Check the appropriate block to identify if this is a partial or
the final claim for the mission (block 1). If there are more claims,
enter the estimated dollar amount required for the

closure of the mission. NOTE: *A separate line entry must be made for
each aircraft / vehicle utilized.*

BLOCK 5A. Enter date expense incurred (as shown on receipt).

BLOCK 5B. Enter type of aircraft or vehicle.

BLOCK 5C. Enter aircraft registry number or vehicle license plate number
corresponding to 5B.

BLOCK 5D. Check appropriate block to identify entry in 5B.

BLOCK 5E. Enter aircraft hours (hobbs) flown for entry in 5B.

BLOCK 5F. Enter the hourly aircraft minor maintenance rate for aircraft
type entered in 5B. Reference current rates published by NHQ CAP/DO.

BLOCK 5G. Multiply the entry in 5E by 5F and enter the result.

BLOCK 5H. Enter the amount claimed for the entry in 5B and attach
original receipt(s).

BLOCK 5I. Enter the amount claimed and attach original receipts.

BLOCK 5J. For consolidated CAPFs 108, the wing calculated the amount
claimed for administration for missions so authorized (CD, INS, etc.).
Add block 5G and 5H. Multiply the result by

15% and enter the result in Block 5J. This calculation is based on
corporate and member owned aircraft and no other items.

BLOCK 5K. Enter the amounts claimed for aircraft oxygen service,
authorized TDY expenses, etc., and attach original receipts.

BLOCK 5L. Enter the sum of 5G through 5K as appropriate.

BLOCK 6. Enter the total of column G.

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.

BLOCK 11. Enter the total of entries in blocks 6 through 10 **OR** total
of column 5L (both should be equal).

BLOCK 12. Read, complete, sign, and date the appropriate block.

**CAPF 108(EF), MAY 02** REVERSE