Fillable Printable Sf 1157 Attendance Certification Part Ii
Fillable Printable Sf 1157 Attendance Certification Part Ii
Sf 1157 Attendance Certification Part Ii
Standard Form 1157 (Rev. 4-80)
Department of the Treasury
CLAIMS FOR WITNESS ATTENDANCE FEES, TRAVEL, AND
1 TFRM 4-2000
MISCELLANEOUS EXPENSES
1157-107
Previous editions obsolete
PART I - ATTENDANCE CERTIFICATION
1. General Information
a. Witness Name
d. Case Name
b. Witness Address
e. Case Number
Street
f. District or Location
City
State Zip
c. U.S. Citizen: Yes ( ) No ( ) Alien: Legal ( ) Illegal ( )
2. Travel and Attendance Information
a. Dates of Travel From Residence to Case Location:
From
To
b. Dates of Travel From Case Location to Residence:
From
To
c. Dates of attendance:
From
To
3.
Certification
I certify that the witness named above attended in the case or matter indicated and is entitled to the statutory allowances for attendance and travel. Inthe
proceedings before United States Magistrate where more than four witnesses were called, the Magistrate also certifies that the approval and certificate of the
U.S. Attorney were first obtained.
(Signature) (Title) (Date)
PART II - WITNESS CLAIM FOR FEES AND ALLOWANCES
Rate No. of Days Amount Claimed
Totals
1. Attendance Fees
a. Fact, Pretrial Conference & Detained Witness
$
Total Attendance Fees
$
2. Mileage Allowance (Indicate type of privately owned vehicle:
(Auto) (motorcycle) (airplane)
Rate No. of Miles Amount Claimed
a. From Residence to Case Location (and Return)
$
b. From Hotel/Motel to Court (or Court to Hotel/Motel)
Total Mileage Allowance
$
3. Subsistence Per Diem Rate: or HRGA Rate:
Rate No. of Days Amount Claimed
(HRGA: High Rate Geological Area)
a. Meals
$
b. Lodging
Total Subsistence Allowance
$
Amount Claimed
4. Miscellaneous Allowances (See Item 8 Below)
a. Common Carrier
$
b. Parking Fees, Tolls, Taxi Fares
Total Miscellaneous Allowances
$
5. Total Amount Claimed (Items 1-4, Part II) $
6. Less Outstanding Check or Cash Advances $
7. New Amount Claimed by Witness $
8. Use this space to itemize your expenses from Item 4, Part II above. Receipts are required for all
common carrier and parking fees, and for all other single items in excess of $15.00.
Paid by Check No.
$
Paid by Cash
(Signature of Payee)
(Date)
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
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Page 2 of SF1157
9. Witness Certification
I certify that the above data is correct and that payment has not been received, and that at the time of travel and attendance I (was) (was not) a U.S.
Government employee and I (was) (was not) a citizen of the United States. (If not a citizen, present your Alien Registration Record with this form.) I
(did) (did not) receive a Government Transportation Request to pay for my official travel.
(Signature) (Date)
PART III - RESERVED FOR FINANCE OFFICE
1. Computation
a. Net Amount Claimed by Witness (From Item 7, Part II) $
b. Adjustments Due to Any Differences (Explain Differences)
c. Amount Authorized for Payment
$
d. By
Title Date
2. Accounting Classification Data
0.00
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