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FUEL/OILTOTAL CLAIMED BY CATEGORY(INSTRUCTIONS FOR COMPLETING THE CAPF 108K(Applicable to all personnel/units submitting reimbursement/payment claims)BLOCK 1.gEnter mission number and mission inclusive dates. Add sequential alpha character to adjustment claims.BLOCK 2.BLOCK 3.9Enter member name (or wing name on the consolidated 108).BLOCK 5. BLOCK 5A.2Enter date expense incurred (as shown on receipt). BLOCK 5B. BLOCK 5C. BLOCK 5D.0Check appropriate block to identify entry in 5B. BLOCK 5E. BLOCK 5F. BLOCK 5G. BLOCK 5H.LEnter the amount claimed for the entry in 5B and attach original receipt(s). BLOCK 5I. BLOCK 5J. BLOCK 5K. BLOCK 5L.BLOCK 6.BLOCK 7.Enter the total of column H.BLOCK 8.Enter the total of column I.BLOCK 9.Enter the total of column J. BLOCK 10.Enter the total of column K.For consolidated CAPFs 108, the wing calculates the amount claimed for administration for missions so authorized (CD, INS, etc.). )member owned aircraft and no other items. All pilots flying on USAF authorized reimbursable missions MUST SUBMIT a CAPF 108 to the wing showing aircraft flown, ownership, and flying time (blocks 5A-K) even if no individual claim for reimbursement is made. This information is required for statistical purposes. Members must submit original CAPF 108 and appropriate receipts to the wing not later than 30 days after the close of the mission  (60-day adjustment period).] Wings must prepare a consolidated mission CAPF 108 and include corporate aircraft expenses.Check the appropriate block to identify if this is a partial or the final claim for the mission (block 1). If there are more claims,  aircraft/vehicle unitized.}enter the estimated dollar amount required for the closure of the mission. NOTE: A separate line entry must be made for eachCCheck the appropriate block for the type mission, one block only! C F41689-00-2-0001O THE CLAIMANT SHALL FORFEIT AND PAY TO THE UNITED STATES THE SUM OF FIVE TO TENITHOUSAND DOLLARS PLUS THREE TIMES THE AMOUNT OF DAMAGES SUSTAINED BY THE 5FIVE YEARS IN PRISON OR BOTH. (SEE 18 U.S.C. 287) RHOURS FLOWN, AUTOMOTIVE FUEL/OIL USED, AND /OR OTHER MISCELLANEOUS COSTS INCURRED.If "Other," describe.'CAP PAYMENT/REIMBURSEMENT DOCUMENT FOR *AVIATION/AUTOMOTIVE/MISCELLANEOUS EXPENSESFOR CAP-USAF USE ONLY*C. CONTRACT/COOPERATIVE AGREEMENT NUMBER:D. OTHER FUNDING SOURCE:;Read, print/type name, sign and date the appropriate block. Dual compensation is prohibited.and supporting documentation. The parties shall not claim costs on the CAPF 108 if expenses are being reimbursed from another source.4A. Mailing Address:BLOCKS 4A & 4B.# Check here if new address < PRINTED/TYPED NAME, OFFICE SYMBOL, SIGNATURE, DATE REVIEWED:Contract/Cooperative Agreement number is F41689-00-2-0001.Enter the hourly aircraft minor maintenance rate for aircraft type entered in 5B. Reference current rates published in CAPR 173-3.RList other funding source, when not funded by the Air Force Cooperative Agreement.;(Enter 0 for Non-CD Mission; Enter 1 for CD Mission [15%]):EA. CAP MEMBER (PRINTED/TYPED NAME): I CERTIFY THAT THE AMOUNTS PAID$SWERE FOR PARTICIPATION IN THE LISTED USAF AUTHORIZED MISSION AND ACCURATELY REFLECTJB. WING COMMANDER OR DESIGNATED OFFICIAL (PRINTED/TYPED NAME): I CERTIFYAFAUTHORIZED MISSION AND THAT THIS CLAIM IS TRUE AND PROPER FOR PAYMENT.YTHE ABOVE EXPENSES ARE A DIRECT RESULT OF SUPPORT/PARTICIPATION IN THE ABOVE LISTED USAF B. TYPE ACFT MAKE/MODELD. ACFTE. ACFT/F. HOURS G. HOURLYH. ACFT I. FUEL ANDK. COMM/ OTHER COSTFLOWN/ NO. MILESEnter aircraft horsepower (hp).5Enter the type of aircraft or vehicle make and model.LEnter aircraft hours(hobbs) flown or number of miles driven for entry in 5B.Enter amounts claimed for communications cost, aircraft oxygen service, authorized TDY expenses, etc., and attach original receipts.8. ADMIN9. OTHER 10. TOTALBLOCKS 11A AND 11B. BLOCK 11C. BLOCK 11D._Enter the total of entries in blocks 6 through 9 OR total of column 5L (both should be equal)..Enter the sum of 5H through 5K as appropriate.11. CERTIFICATIONS. The parties signing in Blocks 11A and 11B are responsible for the accuracy and validity of the facts recited in the claims4Multiply the entry in 5F by 5G and enter the result.Add block 5H and 5I. Multiply the result by 15% and enter the result in Block 5J. This calculation is based on corporate and HP C. ACFT BFor instructions and help, place mouse pointer on triangles (red). ID/VEH ID ORCAPF 108 (E), MAR 03. PREVIOUS EDITIONS WILL NOT BE USED AFTER 30 JUN 03. THIS FORM CANNOT BE MODIFIED. OPR/ROUTING: FM Rq XEnter appropriate mailing address, phone number and e-mail address for entry in block 3.Enter the aircraft registry number or, for corporate-owned vehicles (COV), the vehicle identification number or, for private-ownedEvehicles (POV), the vehicle license plate number corresponding to 5B.!CAPF 108(E), MAR 03. Reverse$4B. 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