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Form D.F.C. 6
1/2020

STATE OF ALABAMA
STATEMENT OF OFFICIAL IN-STATE TRAVEL

Page ___ of ___
(Number pages consecutively)

Unified Judicial System
(Department or Agency)

_____________
(Code Number)

Pay From: ______________________________________Funds

Approved: ___________________________________________

(Department Head)

____________________________________________
Official Station or Base (City where you work)

_____________________________________
Name/Date of Conference or Meeting (if applicable)
Month
and
Date
xx

POINTS OF TRAVEL
(Include Return to Base)
Must be a City

From xx

OFFICE: □ Circ. Ct. □ Dist. Ct. □ Retired □ Clerk
□ Ct. Reporter □ JPO □ AOC □ Other

NAME:

ADDRESS:

________________________________________

________________________________________
________________________________________

Please file monthly.
Above space for name, address, and SSN of traveling employee

Private
Car
Miles
(Enter # of
Miles)

Hours of
Departure

Hours of Return
to Base

A.M.

P.M.

A.M.

P.M.

Amount
Per Diem
Claimed

TOTAL NUMBER OF MILES TRAVELED:

GRAND TOTAL PER DIEM:

Detail miscellaneous expense and furnish receipts when required. This
space for departmental approval, etc. Use extra sheets when necessary.

*MILEAGE (# of miles X $

REGISTRATION/OTHER: $

□

Authorized Overnight per diem for trip less than 100 miles
(See attached Documentation)

GRAND TOTAL EXPENSE THIS CLAIM: $

WAIVER OF PER DIEM
If you are waiving per diem, please (1) check the box
below and (2) sign below:

I HEREBY CERTIFY that the travel and expense indicated hereon was
accomplished in the performance of official duties pursuant to travel
granted me.

□ The traveler hereby waives per diem.
Signature_______________________________

_______________________________________________________

Signature of Traveler
Signature may be an original, copy, or electronic signature (e.g. '/s/ John Doe')
Please do not include two fiscal years on one claim

COMPLETE IN FULL. FAILURE TO PROVIDE COMPLETE INFORMATION COULD RESULT IN PROCESSING DELAYS.
PLEASE SIGN NEXT TO ANY CORRECTIONS MADE ON THIS FORM.

*Round to the nearest whole cent
**Carry all Grand Totals forward to last page

AOC USE ONLY: _____________________

Code

0301$___________________
0303$___________________
0307$___________________

0309 $___________________
0916 $___________________

Date:________________________________

Statement of Official Travel 2020

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Alabama state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from eforms.alacourt.gov (2023-03)
Page(s): 1
Fields(s): 146
Average fields per page: 146
Reading Level: Grade 9
LIST Grouping(s): GO-00-00-00-00.

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Statement of Official Travel 2020

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02