Return to: Anna Wyatt

IMPORTANT

Please attach travel and other receipts. See other side.

AMERICAN HEART ASSOCIATION

44 East 23rd Street
New York, N.Y. 10010

EXPENSE VOUCHER

Your personal participation is vital to the success of the work of the American Heart Association and reimbursement is provided for your expenses. There are Board and Committee members who prefer to pay their expenses as part of their contribution to the Association. In those instances where expenses are not charged they are deductible for income tax purposes.

PLEASE PRINT OR TYPE

NAME 1 Robert E Shank, M.D
2 16 44
ADDRESS 2 Head, Department of Preventive Med.
2 16 44
3 Washington Univ.-School of Med.
2 16 44
4 4566 Scott Avenue
2 16 44
5 St. Louis, Missouri 63110
2 16 44

ALL CARDS

ORGANIZATION AGENCY CONTROL NO.
0 0 1 0 0 1
72 74 75 77 93 96

ACCOUNTING
ONLY

TRANSPORTATION: AIR FARE (TOURIST) $__________
(NOTE 1)

AUTO (MILEAGE) X. 13¢ $__________

RR/BUS/TAXI/LIMOUSINE $__________

HOTEL (__________) DAYS) CHARGED TO AHA YES (NOTE 2) XXXX
NO

SUBSISTENCE (MAXIMUM $15.00 PER DIEM) (NOTE 3) $__________

TOTAL $__________

FOR AHA ACCOUNTING USE ONLY

DATE	BUDGET CHARGE	12	14	15	16	BAL/	18	19	21	22	24
		LOC		FUND	FUNC		OBJ		CST	CNTRE
6												$ 25
11												33
DATE	BUDGET CHARGE	12	14	15	16	BAL/	18	19	21	22	24
		LOC		FUND	FUNC		OBJ		CST	CNTRE
												$ 25
												33

X

2

A

2

B

2

MEETING Program Committee DATE 5 / 28 / 75 BUDGET 506-830

MEETING DATE 5 / 29 / 75 BUDGET __________

HELD AT Biltmore Hotel, New York City

PERSONAL SIGNATURE

APPROVED BY

EDP/U 1007

Source: https://www.industrydocuments.ucsf.edu/docs/pyyf0227