[104-10225-10006.pdf — page 223]
# SECRETREPORT OF SERVICE ABROADTO:Office of Personnel Control Division, Statistical Reporting BranchSERIAL NO.: 036130NAME:FLORES DANIELINSTRUCTIONSUSE APPROPRIATE SPACE BELOW TO REPORT DATA FOR EITHER PCS OR TDY. INSERT APPROPRIATE CODE NUMBER IN "CODE" COLUMN TO DESIGNATE WHETHER SUBMISSION IS OF BASIC DATA, CORRECTION, OR CANCELLATION (One only). REPORT DATES BY USING THE NUMBER FOR THE MONTH. AND LAST TWO DIGITS ONLY FOR YEAR. REFER TO OFI NO. 30. REVISED.## PCS DATES OF SERVICE|                 | ARRIVAL O/S |       | DEPARTURE O/S |       |       | O/P  | COUNTRY  |       || --------------- | ----------- | ----- | ------------- | ----- | ----- | ---- | -------- | ----- || MONTH           | DAY         | YEAR  | MONTH         | DAY   | YEAR  | CODE | USE ONLY | CODE  || 25-26           | 27-28       | 29-30 | 31-32         | 33-34 | 35-36 | 37   | 38 39    | 40-42 ||                 |             |       |               |       |       |      |          |       || TYPE OF DATA    |             |       |               |       |       |      |          |       || 1. PCS (Basic)  |             |       |               |       |       |      |          |       || 3. CORRECTION   |             |       |               |       |       |      |          |       || 5. CANCELLATION |             |       |               |       |       |      |          |       |## TDY DATES OF SERVICE|                 | ARRIVAL O/S |       | DEPARTURE O/S |       |       |      |              |         |      || --------------- | ----------- | ----- | ------------- | ----- | ----- | :--: | ------------ | ------- | ---- || MONTH           | DAY         | YEAR  | MONTH         | DAY   | YEAR  | CODE | O/P USE ONLY | AREA(S) | CODE || 25-26           | 27-28       | 29-30 | 31-32         | 33-34 | 35-36 |  37  | 38 39        | 40-42   |      || 12              | 08          | 75    | 12            | 13    | 75    |  2   | WH           | 811     |      ||                 |             |       |               |       |       |      | AREA         |         |      || TYPE OF DATA    |             |       |               |       |       |      |              |         |      || 2. TDY (Basic)  |             |       |               |       |       |      |              |         |      || 4. CORRECTION   |             |       |               |       |       |      |              |         |      || 6. CANCELLATION |             |       |               |       |       |      |              |         |      |OFFICE OF PERSONNEL USE ONLY - PUNCH AREASOURCE DOCUMENT AND CERTIFICATIONTRAVEL VOUCHER DISPATCHCABLE DUTY STATUS OR TIME AND ATTENDANCE REPORTOTHER (Specify)DOCUMENT IDENTIFICATION NO.: 24-07-76DOCUMENT DATE/PERIOD: Dec 3-13-75REMARKS|                     | PREPARED BY |     | REPORT ANNOTATED ON CONTROL DOCUMENT | ABOVE DATA CERTIFIED CORRECT, BASED UPON SOURCE DOCUMENT CITED || ------------------- | ----------- | --- | ------------------------------------ | -------------------------------------------------------------- || DCO                 |             |     |                                      |                                                                || B L DIVISION. CTDB. |             |     | DATE                                 | SIGNATURE                                                      || C B DIVISION        |             |     |                                      |                                                                |THIS REPORT WILL BE FILED IN THE OFFICE OF PERSONNEL IN THE INDIVIDUAL'S OFFICIAL PERSONNEL FOLDERSECRETFORM 145184-71OBSOLETE PREVIOUS EDITIONS