NASA AMES RESEARCH CENTER

REIMBURSABLE TRAVEL DATA SHEET

To be completed by ARC Division/Directorate: Attach this document to the
appropriate travel authorization request, and forward to ARC Office of
Chief Counsel for review.

SECTION I -- BASIC DATA

1\. **Name of Traveler/Employee:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

2\. **Title and Code:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

3\. **Travel Itinerary:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

4\. **Travel Dates (from/to):
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

5\. **Purpose/Justification:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

SECTION II -- CHECKLIST

6\. **Is the payment for the employee's attendance at a "meeting or
similar function"?** Namely: a conference, seminar, speaking engagement,
symposium, training course, or similar event that takes place away from
the employee's official station and is sponsored or cosponsored by a
non-Federal source. This term does **not** include a meeting or other
event required to carry out an agency's statutory or regulatory
functions (i.e., a function that is essential to an agency's mission),
such as investigations, inspections, audits, site visits, negotiations,
or litigation. The term also does **not** include promotional vendor
training or other meetings held for the primary purpose of marketing the
non-Federal source's products or services, or long term TDY or training
travel. (*See* 41 CFR 304-2.1) The term also is interpreted **not** to
include travel that exceeds three weeks' duration. (*See* Federal
Register, Vol. 57, No. 217, Monday, November 9, 1992.)

## Yes: No: 

7\. **Is the payment for travel, subsistence, and related expenses**
(e.g., conference or training fees) **which are incident to the meeting
or similar function?** (*See* 41 CFR 304-3.4)

## 

## Yes: No: 

8\. **Is the payment from a non-Federal source** (i.e., any person or
entity other than the Government of the United States)**?** Note: This
includes any individual, private or commercial entity, nonprofit
organization or association or international or multinational
organization (irrespective of whether an agency holds membership in the
organization or association), or foreign, state, or local government
(including the District of Columbia). (*See* 41 CFR 304-2.1.)

## 

## Yes: No: 

9\. **Would a reasonable person with knowledge of all relevant facts
question the integrity of agency programs or operations as a result of
the payment?** This analysis is based upon the following factors: (A)
the identity of the non-Federal source; (B) the purpose of the meeting
or similar function; (C) the identity of other expected participants;
(D) the nature and sensitivity of any matter pending at the agency
affecting the interest of the non-Federal source; (E) the significance
of the employee's role in any such matter; and (F) the monetary value
and character of the travel benefits offered by the non-Federal
source)**?** (*See* 41 CFR 304-5.1 and 304-5.3.)

## 

## Yes: No: 

#### Explanation, if applicable: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

10\. **Will the employee's spouse be accompanying the employee to the
meeting or similar function pursuant to an official travel
authorization?** (*See* 41 CFR 304-3.14.)

## 

## Yes: No: 

11\. **If so, will the spouse\'s travel, subsistence, and related
expenses be paid for by a non-Federal source?**

## 

## Yes: No: N/A:

12\. **Did the employee, or any other NASA representative, solicit the
payment from the non-Federal source?** (*See* 41 CFR 304-3.5.)

## 

## Yes: No: 

13\. **Will any money from a NASA grant, a NASA cooperative agreement,
or a NASA contract be used to fund the payment or other related
expenses?**

## 

## Yes: No: 

14\. **Has the Director (permanent or acting) of the employee\'s
Directorate authorized the proposed reimbursable travel arrangements and
signed, personally, the reimbursable travel orders?**

## 

## Yes: No: 

15\. **Will the meeting or similar function occur outside of the United
States of America?**

## 

## Yes: No: 

SECTION III -- REMARKS (if applicable)

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

SECTION IV -- DIVISION/DIRECTORATE SIGNATURE

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

Name Date

SECTION V -- LEGAL OFFICE RECOMMENDATION

## 

## Approve: Disapprove: 

**Remarks (if applicable):
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

Name Date