Department of state


Miscellaneous Expense Portion



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_______Miscellaneous Expense Portion:




  • Two ways to claim: (1) Flat rate or (2) Itemization

  • Flat rate: No receipts required $650 without family; $1,300 with family

  • Itemization: Receipts required. Limits are based on salary (DSSR 252.1). Allowable expenses listed in DSSR 251.2a

  • May be paid between foreign location and U.S.

_______Wardrobe Expense Portion:




  • Paid only when transferring across two transfer zones (1 to 3 or 3 to 1)

  • May be paid between foreign location and certain non-foreign areas outside conterminous U.S.

  • Never paid to conterminous U.S. (48 contiguous states + the District of Columbia) which is zone 2

  • Zones for foreign areas found in DSSR 920, column 4

  • Zones for non-foreign areas found in DSSR 252.2

  • Paid as flat rate depending on family size, no receipts required (see DSSR 252.2 for current amounts)

_______Subsistence Expense Portion:




  • Paid only when transferring from foreign post to the United States (DSSR 251.1c).

  • Paid by either Actual subsistence method or Flat rate method

If Agency offers both methods, then employee chooses method of reimbursement prior to commencement of HSTA.

If Agency does not offer both methods, Actual subsistence method is used.



Actual subsistence method: Paid up to 60 days with an additional 60 days allowed with agency approval; receipts required

for lodging; certified meal/laundry/dry cleaning statement required, but no receipts.



  • Flat rate method: No receipts required, limited to 30 days

_______Lease Penalty Expense Portion:



  • Paid from post in foreign area to United States

  • Authorizing official must certify in writing to five statements in DSSR 252.4

  • Amount allowed limited to terms of lease or three months’ rent, whichever is less.

DSSR Section 960 - Worksheets (TL:SR 711 7/5/09) HSTA- page 2 of 2



EDA - Education Allowance Worksheet (DSSR 270)(Rev. 7/22/07 TL:SR 679)

Allowable expenses under the Education Allowance may be computed here to process a claim on the SF-1190. This worksheet is reproducible locally. See guidelines

on the reverse of this page.

Employee’s Name (Last, First, MI)


Agency

Date

Grant Number



Name of Child/Date of Birth (mm/dd/yy)



Name and Address of School



At-post


Away-from-post


Home

study

U.S.

Grade

Equiv.

Date Child

Enters

School

Date Child

Leaves

School

1.























2.























3.























4.























5.























6.























7.























8.























Methods of education described on reverse side of worksheet




Child 1

Child 2

Child 3

Child 4

Child 5

Child 6

Child 7

Child 8

Basic tuition


























Necessary

electives



























Books and supplies
























Local transportation

(At-post only)



























AP or IB exam fees (see DSSR 271i)

























Away-from-post

transportation



























Room and board

(Away-from-post)




























Subtotal

























One-time fees


























English as a second

language


























Supplementary

instruction




























Total

























Home study/Private Instruction

(Grades K-12)






























Remarks: Include exchange rate used if costs in local currency. Area for prorating allowance if necessary (DSSR 274.22f) and for figuring local transportation when private car or carpool used (DSSR 277.1f)


DSSR Section 960 - Worksheets (TL:SR 679 07/22/07 ) Education Allowance - page 1 of 2

EDA - Education Allowance Worksheet (DSSR 270) (Rev. 7/22/07 TL:SR 679)
Employee must choose one of the three methods of education: (1) At-post (2) Away-from-post or (3) Home Study/Private Instruction.
(DSSR 276.3) Education allowances shall not be paid for a child in the U.S. who (1) has a parent in the U.S. (unless divested of custody); (2) is under Separate Maintenance Allowance. An Education Allowance shall not be paid for a child who has traveled under educational travel authority within the past 12 months (DSSR 276.3).
An Education Allowance may be paid for a child who is under Involuntary SMA if attending school at an authorized foreign ISMA point (unless they have traveled under educational travel authority within the past 12 months).


(1) School at-post (DSSR 277.1) Allowance rates in DSSR 920, column 5

If “At-post” and “Away-from-post” allowances in DSSR 920 are the same, the school at post is considered adequate.



Allowable expenses:

Basic tuition

Necessary electives

Books and supplies normally provided free of charge in U.S. public schools

Required fees (one-time fees limited to base school; see DSSR 272.3 when limit is reached)

Local transportation

Supplementary instruction reimbursement (see DSSR 274.12a and 276.9 for details)




(2) School Away-from-post (DSSR 277.2) Allowance rates in DSSR 920, column 5

. If “At-post” and “Away-from-post” allowances in DSSR 920 are not the same (i.e., “away” is higher), the school at post is considered inadequate.



Allowable expenses:

Basic tuition

Necessary elective courses

Books and supplies normally provided free of charge in U.S. public schools

Required fees

Room and board (277.2b)

Periodic transportation to/from post during school closings; UAB or storage of baggage at or in the vicinity of the school during break between school years (see 277.2c)




(3) Home Study/Private Instruction (277.3)

Grades K through 8 are based on the Calvert School, Baltimore, Maryland

Grades 9 through 12 are based on the University of Nebraska

Current rates are in 274.12b

Rates are set to include all necessary curriculum costs



(4) Special Needs Education Allowance (276.8)

Current “At-post” and “Away-from-post” rates are in 274.12c. See 276.81 when costs exceed maximum.

Rates are in lieu of, not in addition to, the “At-post” and “Away-from-post” rates listed in DSSR 920

Documentation at post must include Individual Education Plan (IEP) or equivalent

or Individual Family Service Plan (IFSP) which delineates educational requirements

DSSR Section 960 - Worksheets (TL:SR 679 eff. 7/22/07) Education Allowance - page 2 of 2



EPW – EVACUATION PAYMENTS WORKSHEET (DSSR 600)

(Page 1 of 2)

Safehaven Location used to calculate the Subsistence Expense Allowance (SEA). If within the U.S., include name of county to further identify safehaven location. Note: There can be only one First Evacuee at each Official Safehaven (see reverse of this page for details).

___________________________________________________________________________________________________________

City County (U.S. only) U.S. State or Country
Safehaven Lodging (“L”) $__________________

Meals & Incidental Expenses (“M&IE”) $___________________


Safehaven Advance Received $____________________

The commercial rate requires a receipt for lodging in a hotel, motel, commercially leased house or apartment, or other transient-type commercial establishment.






Commercial Rate

Days 1 through 30



Commercial Rate

Days 31 through 180



First Evacuee (may be either employee or family member)


100% x L = _____________


100% x M&IE = _________

100% x L = _______________


80% x M&IE = ____________

Each additional evacuee 18 & over




100% x M&IE = _________




80% x M&IE = ____________


Each additional evacuee under 18




50% x M&IE = __________




40% x M&IE = ____________



SPECIAL FAMILY COMPOSITION CONSIDERATION

(Check Only One)
________First Evacuee plus one (non-spouse/non-domestic partner family member, age 18 and older).

________First Evacuee plus one (non-spouse/non-domestic partner family member of opposite gender, age 12 and over).

________First Evacuee plus two (one non-spouse/non-domestic partner family member, age 18 and older; or one non-spouse family member, opposite gender, age 12 and older)

________First Evacuee plus three (one non-spouse/non-domestic partner family member, age 12 and over).

________First Evacuee plus four or more family members.

________NOTE: For special family composition consideration not addressed above, submit request through agency to the Director, Office of Allowances (A/OPR/ALS), U.S. Department of State, Washington, D.C. 20522-0103.


See reverse for further explanation of the commercial rate and application of 50% above the 100% lodging level when the special family composition applies.


The “non-commercial” rate will apply for days when a receipt for a commercial establishment is not received.




Non-Commercial

Days 1 through 30



Non-Commercial

Days 31 through 180


First Evacuee (may be either employee or family member)


10% x L = ___________


100% x M&IE = ________

No lodging amount paid


80% x M&IE = ___________

Each additional evacuee 18 and over

100% x M&IE = ____________


80% x M&IE = ___________



Each additional evacuee under 18

50% x M&IE = _________


40% x M&IE = ___________



DSSR Section 960 Worksheets (TL:SR 813 6/2/13) Evacuation Payments - Page 1 of 2

EPW - EVACUATION PAYMENTS WORKSHEET (DSSR 600)

(Page 2 of 2)



Additional Evacuation Payments


  • In addition to SEA payments, a transportation allowance may be paid as follows: $25 per day, regardless of family size. LIMITATION: The transportation allowance may not exceed $25 per day per family and may be paid at only one safehaven even if evacuees from the same family are at two different safehavens.




  • An air freight replacement allowance may be paid if air freight was not shipped FROM post. Employees and evacuated family members will still be eligible to ship air freight BACK TO post. Amounts are: $250 for first evacuee only; $450 for first evacuee and one family member; $600 for first evacuee and two or more evacuated family members. If evacuees are at two safehavens, there can be a first evacuee at each safehaven when calculating the air freight replacement allowance [see examples at DSSR 631a(3).]


Internet Sources for All Per Diem Rates
--48 states and DC (continental US) = GSA (Per diems are first listed by county. Exceptions are noted. If there is not a separate listing, per diem rate used to calculate SEA should be standard CONUS rate) http://www.gsa.gov/portal/category/21287

--Non-Foreign, outside continental US = DOD http://www.defensetravel.dod.mil/site/perdiem. cfm



--All Foreign Locations = STATE http://aoprals.state.gov/web920/per_diem.asp

Basic rules for determining SEA payments
Safehavens are designated by the Secretary of State and may include (1) U.S. and/or foreign safehavens (DSSR 614a) as well as (2) alternate safehavens (DSSR 614c). It may be necessary to designate more than one official (U.S. and/or foreign) safehaven (DSSR (610l). If you are at your U.S. or foreign safehaven, SEA is calculated using the per diem rate for your safehaven. There can be only one first evacuee at each U.S. or foreign safehaven (except married couple employees or domestic partnership employees may each be calculated as first evacuee). The official safehaven of the first evacuee is used to determine payments for all evacuated family members at that safehaven. Example: Employee (designated as first evacuee) is at the U.S. safehaven (and physically located in Washington, D.C.) and family members are at the U.S. safehaven (and physically located in Iowa), payments for employee and family members would be calculated based on the per diem rate for Washington, D.C. (location of the first evacuee). If family members are at an alternate safehaven, SEA is calculated using the LOWEST of the per diem rates for the following: (a) official (U.S. or foreign) safehaven; (b) alternate safehaven; or (c) Continental US (CONUS) [as of 10-01-12, that is $123 ($77 for lodging; $46 for M&IE)]. Restriction: If there is a first evacuee at either a U.S. or foreign safehaven there cannot also be a first evacuee at the alternate safehaven for SEA payments. The SEA in this case would be calculated using the formula for “each additional evacuee” using the lowest of the above per diem rates.
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