STANDARD FORM OF FLIGHT CERTIFICATE AND SCHEDULE [General Regulations No. 64-Supplement No. 1] OCTOBER 31, 1928. 1. In order to simplify the preparation of the necessary flight cortificate and schedule in support of payments of flying pay to enlisted men of the Army, Navy, Marine Corps, and Coast Guard, under the provisions of section 20 of the act of June 10, 1922, 42 Stat. 632, as amended by the act of July 2, 1926, 44 Stat. 780, and the Executive order of March 10, 1927, pursuant thereto, there is hereby prescribed Standard Form No. 1051a, Flight Certificate and Schedule (Enlisted Men), for use in lieu of Standard Form No. 1051, if desired, where payments for flying duty are made by a disbursing officer in an accounting period to a number of enlisted men. Standard Form No. 1051 will continue to be used in support of payments of flying pay to officers, and when used to support payments of flying pay to enlisted men it need not be signed by them in space provided for signature of flyer. 2. The certificate and schedule for enlisted men, duly signed and otherwise completed, will become the authority of the disbursing officer for paying the increased flying pay claimed. It will be attached to the pay voucher or roll to which it pertains and will accompany the accounts of the disbursing officer to the General Accounting Office. As many copies may be retained for administrative purposes as are required. 3. Every flight certificate and schedule should bear an identifying number, either pay number, voucher number, or other reference number, for which space is provided in the upper right-hand corner of the standard form. 4. A copy of the orders to fly in each case must accompany the flight certificate and schedule to which it relates, or, if a copy has previously been filed, notation to that effect must be made on the certificate under the name of the flyer, showing the voucher number, month or quarter of account with which filed, and name of the disbursing officer. 5. Upon receipt of these regulations the departments and independent establishments concerned are requested to make requisition at once upon the Public Printer for a supply of the standard form estimated to be required for the period ending June 30, 1929. It is understood and agreed by said departments and establishments that they thereby consent to the plan of combining all the requisitions submitted and printing one edition, to be delivered to the respective departments and establishments, or placed in stock at the Government Printing Office subject to their order, or partly placed in stock and partly delivered, as the case may be, and that they authorize the Public Printer to prorate the cost of printing and render bill against each department and establishment for its proportionate share on the basis of the number of blanks ordered by it. This procedure will be followed at the beginning of each fiscal year or oftener as may be required by the Public Printer. The Public Printer will deliver the blanks as needed upon supply requisition therefor, and will keep an accurate account with each department and independent establishment, showing the quantities ordered by and delivered to each and the balance due. J. R. MCCARL, Comptroller General of the United States. I hereby certify that during the above-mentioned flying periods the men whose names appear above performed the flights listed hereon under orders issued by competent authority, filed herewith or as indicated above; that they fulfilled the flying requirements prescribed by Executive order of March 10, 1927, under conditions specified therein and in the flying orders referred to, and that this certificate is made after checking the flight log book or record of said flyers with the aircraft log books or records of the aircraft in which they made the flights listed in this schedule, which is certified to be correct. 19.. (Date of certificate) (Signature) (Rank) Commanding. In case copies of orders have been previously filed, reference to where filed shall be stated under the name of each flyer, showing in each case the voucher number, month or quarter of account with which filed, and name of the disbursing officer. Show separately each authorized flying period. Insert "N. T." in case flying status has not terminated. Where more than one flight is made in one day indicate in parenthesis the number of flights on such days. Example: "Jan. 6, 9 (3), 12, 14 (2).” STANDARD FORM OF PAY VOUCHER FOR SIX MONTHS' DEATH GRATUITY PAY [General Regulations No. 68] AUGUST 4, 1928. 1. For use in making payment of six-months' death gratuity pay to beneficiaries of officers, enlisted men, and nurses of the Army, Navy, Marine Corps, and Coast Guard under the acts of December 17, 1919, 41 Stat. 367, and June 4, 1920, 41 Stat. 824, as amended, Standard Forms No. 1057 (original) and No. 1057a (memorandum) are hereby prescribed and will be used in lieu of all other forms authorized and/or used for the purpose. 2. The provisions of this regulation are immediately effective, subject to the availability of the new form upon prompt printing and distribution thereof, but in no case will the old forms be used later than October 1, 1928. 3. Upon receipt of these regulations the departments concerned are requested to make requisition at once upon the Public Printer for a supply of the standard forms estimated to be required for the period ending June 30, 1929, at the same time authorizing the destruction or other disposition of old plates, etc., pertaining to forms now in use. It is understood and agreed by said departments that they thereby conscnt to the plan of combining all the requisitions submitted and printing one edition to be placed in stock at the Government Printing Office, subject to their order, and that they authorize the Public Printer to prorate the cost of printing and render bill against each department for its proportionate share on the basis of the number of blanks ordered by it. This procedure will be followed at the beginning of each fiscal year or oftener as may be required by the Public Printer. The Public Printer will deliver the blanks as needed upon supply requisitions therefor, and will keep an accurate account with each department, showing the quantities ordered by and delivered to each and the balance due. The certification by the Public Printer, or by his authority, that the blanks covered by a bill have been printed and placed in stock subject to order of a department, or partly placed in stock and partly delivered to said department, as the case may be, may be accepted as evidence of delivery within the meaning of section 3648 of the Revised Statutes and, if otherwise correct, authorize payment of the bill as provided by law. J. R. MCCARL, Comptroller General of the United States. Standard Form No. 1057 Form approved by Comptroller General U. S. U. S... August 4, 1928 Voucher No...... PAY VOUCHER FOR SIX MONTHS' DEATH GRATUITY PAY Appropriation...... (Department and bureau or office) Paid by (The following certificate will be executed in case beneficiary or beneficiaries is (are) wife, minor male child or children, unmarried female child or children, or undesignated dependent grandparent, parent, sister, or brother whose authority to receive the gratuity pay on account of dependency has been determined by the head of the department as per statement to be hereto attached:) I (we) certify that I am (we are).. (State relationship) of the above-named decedent, and, as child or children claiming, there were no other minor children living at time of decedent's death; that I am (we are) authorized as..... (If designated, so state) beneficiary or beneficiaries (or representative of beneficiary or beneficiaries as per court evidence attached) to receive the six months' death gratuity pay; that the foregoing statements of fact are correct, and that payment therefor has not been received. (The following affidavit will be executed in all other cases to which the preceding certificate does not apply:) I (we) do solemnly swear that I am (we are)..................... (State relationship) of the above-named decedent, and, as child or children claiming, there were no other minor children living at time of decedent's death; that I am (we are) authorized as........... (If designated, so state) beneficiary or beneficiaries (or representative of the beneficiary or beneficiaries as per court evidence attached) to receive the six months' death gratuity pay; that the foregoing and following statements of fact are correct, and that payment therefor has not been received. (NOTE.--If affiant(s) is (are) married female child or children, or child or children over 21 years of age, or designated dependent grandparent, parent, sister, or brother, or undesignated dependent grandparent, parent, sister, or brother whose authority to receive the gratuity pay on account of dependency has not been determined by head of department, age, marital status, and facts showing dependency should be set forth in this affidavit; if affiant is a dependent relative not included among those heretofore described, the facts called for by the affidavit must be stated in full in proof of actual dependency.) 2. Age...... 1. Married or single: 3. Occupation: . 4. Income from all sources: (Continued on next page) Paid by check(s) No.(s).................., dated......................... for $...... on Treasurer of the United States in favor of payee(s) named above. 10. State whether or not any of your relatives contribute to your support, and if so, to what extent: 11. Amount of all contributions made to your support by the deceased officer, enlisted man or nurse, per month, for at least one year immediately prior to his or her decease: 12. Any other facts tending to show your dependency upon the decedent: county of both of State of who, being duly sworn, say that they are personally well acquainted with the above-named payee(s); that they have read the statements made by said payee(s), and that said statements are true to the best of their knowledge and belief. (Signature by mark must be witnessed) (Sign original only) (Signature by mark must be witnessed) (Sign here) (Sign here) Subscribed and sworn to before me by payee(s) and corroborating witnesses at this day of ................ 19.. I certify that the above-named payee (s) has (have) by been designated as beneficiary or beneficiaries, (not) decedent; that if designated, the designation described in this voucher is correct as shown by the records of this office; that the payee (s) named is (are) authorized to receive the six months' gratuity pay on account of the death of the decedent, and payment thereof is approved in the sum of $...... (Signature) (Title) Standard Form No. 10578 Form approved by Comptroller General U. S. August 4, 1928 MEMORANDUM PAY VOUCHER FOR SIX MONTHS' DEATH GRATUITY PAY Voucher No. ...... (Acts December 17, 1919, 41 Stat. 367, and June 4, 1920, 41 Stat. 824, as amended) (The following certificate will be executed in case beneficiary or beneficiaries is (are) wife, minor male child or children, unmarried female child or children, or undesignated dependent grandparent, parent, sister, or brother whose authority to receive the gratuity pay on account of dependency has been determined by the head of the department, as per statement to be hereto attached:) I (we) certify that I am (we are) .. (State relationship) of the above-named decedent, and, as child or children claiming, there were no other minor children living at time of decedent's death; that I am (we are) authorized as (If designated, so state) beneficiary or beneficiaries (or representative of beneficiary or beneficiaries as per court evidence attached) to receive the six months' death gratuity pay; that the foregoing statements of fact are correct, and that payment therefor has not been received. (The following affidavit will be executed in all other cases to which the preceding certificate does not apply:) I (we) do solemnly swear that I am (we are) (State relationship) of the above-named decedent, and, as child or children claiming, there were no other minor children living at time of decedent's death; that I am (we are) authorized as (If designated, so state) beneficiary or beneficiaries (or representative of the beneficiary or beneficiaries as per court evidence attached) to receive the six months' death gratuity pay; that the foregoing and following statements of fact are correct, and that payment therefor has not been received. (NOTE. If afflant(s) is (are) married female child or children, or child or children over 21 years of age or designated dependent grandparent, parent, sister, or brother, or undesignated dependent grandparent, parent, sister, or brother whose authority to receive the gratuity pay on account of dependency has not been determined by head of department, age, marital status and facts showing dependency should be set forth in this affidavit; if affiant is a dependent relative not included among those heretofore described, the facts called for by the affidavit must be stated in full in proof of actual dependency.) |