U. W. Form 17 4-39--10M 
THE UNIVERSITY OF WISCONSIN 
Travel Expense Form 
Use Ink, Indelible Pencil or Typewriter 
See reverse side for travel regulations            Madison, Wis.    Date----
JOY3-------------- 19 140 
Account of  Fredrick    .               J.                       Address
  Ol     toM1o9      Building 
PURPOSE OF TRIP- 144,d- _      $ -4"-_    4t lr--------- Receipt 
Qicka     Inve~tigntion. (Jueo work consited of           Number 
obs" rvatimns     work on nests and boomiN- 
grouns. ) 
June       1  40   Vic. of 3-bcok ek, 
C. 7   I.    £                           0.14 
Vie. of B bcock to 
vie. of Plainfind              46 
3.5 g    .    s                          0.686 
2        Vic. of Pla7i0feld            10 
Vic. of PleainrlId 
to vie. of      eedikh        68 
9.9 cal. g                                1.90             1            1
9o 
3        Vic. of    Iecel-l            59 
4.2 gal.      o                           0.8 s82 
7        Vie. of     "Crs  i to 
vic. of    a   ,bcock         27 
2.0 gal. gzs                              f.39                          
  39 
5        Vic. of 3abcocL to 
vie. of Plainfield            46 
3.5 gal    ga                              .6a                          
 69 
10        Vic. of Plai.    field         34 
2.5 gal. c-1-1                            0.149                         
 149 
11        VIc. of Plainfield to 
6.0 ga.       P, oi                      1.63             2            1
63 
14        Sparti to vic. Flainf.        90 
4.5 gAl. ga3                              0.8 
15        Vie. of ?1a1fS,4ed           1? 
0.8 gal. g                                0.16                          
 16 
19        Vic. of Plainifield           35 
2.5   al. gas                            o.49                           
 49 
25        Vic. of Plairifiold            44 
3.5 &A                                    0.63                      
     69 
Total 
Audited  For  $ -------------  by -------------------------- 
Approved -----------------------------------------   Div. 
Dept ..--------------------------- Req. $ -------------- 
Approved ---------------------------------------------- Class -----------------------------
Dept.   ------------- 
Fund ----------------------------- Activity. 
STATE OF WISCONSIN,         t 
County of ----------------------------------------------------------------------------------,
being duly 
sworn, says that the within  account of services and daily  expenses amounting
 in  all to --------------------------------- 
dollars, is just, correct and true; that the sums charged were actually disbursed
by him for the State of Wisconsin, as 
stated in the account, and that no part of the same has been paid for. That
no part of the expenses of travel herein 
charged for has been had upon a free pass or free transportation of any nature
whatever, and the amount herein charged 
as a disbursement for transportation or for other expenses incident to travel
has been actually paid out. 
Subscribed and sworn to before me this-------.......... 
day of ---------------------------------- , A. D. 19 .... 
Notary Public.