ࡱ> GIF rbjbj &:jj[l 8* ,V | rP P P P P RL$C cQ2P P 228P P G8882P P 828844P > ۘ 244]04 8 48VEHICLE REIMBURSEMENT REQUEST (REHABILITATION/WINDSHIELD REPLACEMENT) TO: NHQ CAP/LGTDate (mmm dd yy): FORMTEXT      Part I. General Information/Point of Contact.Wing: FORMTEXT      Wing Vehicle ID No.: FORMTEXT      No. of Pages: FORMTEXT    Name: FORMTEXT      Phone:( FORMTEXT    )  FORMTEXT      Title: FORMTEXT      Fax:( FORMTEXT    )  FORMTEXT       Part II. Use Only For Vehicle Rehabilitation Reimbursement Request. Attach estimate(s) for maintenance required (paint requests require two estimates and photos of vehicle).Tires (1-4): FORMTEXT      Control Number: FORMTEXT      Battery (1 or 2): FORMTEXT      Control Number: FORMTEXT      Safety (specify type work): Control Number: FORMTEXT       FORMTEXT      Paint Job:  FORMCHECKBOX  Yes  FORMCHECKBOX  NoControl Number: FORMTEXT      Part III. Use Only For Vehicle Self Insurance (VSI) Windshield Replacement Request.Windshield Replacement (specify type work):Control Number: FORMTEXT       FORMTEXT       Wing/Region Commander (or designated alternate) Signature Fax completed form to NHQ CAP/LGT for processing and fax a copy to State Director (information). CAP FORM 70, SEP 03 PREVIOUS EDITIONS WILL NOT BE USED AFTER 30 NOV 03 OPR/ROUTING: LGT frt  "(*,.:<PRṰ̭̭̭ujOJQJU^JjvOJQJU^JjOJQJU^JjOJQJU^J jOJQJU^JmHnHujOJQJU^JjOJQJU^J6CJOJQJ]^J5CJOJQJ\^J OJQJ^J5OJQJ\^J.oo$$Ifs\ $$7 `  4 sa$8x$If^8a$x$If$a$ qdfr,ǐ 8x$If^8x$If8$$Ifs4$k%4 sa ,.:bpi,aaRa$8x$If^8a$x$If$$Ifsֈ<p#$@44xl;4 saT^`bprt &(.0DFHRTXZݹݫݝݏ݁~x~ 5CJ\CJj:OJQJU^JjOJQJU^JjNOJQJU^JjOJQJU^JjbOJQJU^J5OJQJ\^J5CJOJQJ\^J OJQJ^JjOJQJU^J jOJQJU^JmHnHu/V(x$8x$If^8a$x$Ifo$$Ifs\$@;4 saVXZOGGx$If8$$Ifs4/$`%4 sa$Ifo$$Ifs\$@;4 sa 4 6 8 B D F H l n   8 : N P R \ ^ ` b tjOJQJU^J5>*CJOJQJ\^J5OJQJ\^JjOJQJU^JjOJQJU^Jj&OJQJU^J jOJQJU^JmHnHujOJQJU^JjOJQJU^J5CJOJQJ\^J OJQJ^J- F H l x,o$$Ifs\<$@4  ,4 sax$If$8x$If^8a$  8 ` | $x$Ifa$x$Ifo$$Ifs\<$@4  ,4 sa` b d f h j 0T^$$Ifs4(F$l ,    4 sa $x$Ifa$x$If^$$Ifs4hF$l ,    4 sab f h j l   , . B D F P R T V   \ ^ | ~ عuعgj5OJQJU\^Jj\OJQJU^J%j5CJOJQJU\^J%jt5CJOJQJU\^Jj5CJOJQJU\^J jOJQJU^JmHnHujOJQJU^JjOJQJU^J5OJQJ\^J OJQJ^J5CJOJQJ\^J(j  $x$Ifa$ 1x$Ifx$If8$$Ifs4$#X4 sa<$If , T pzo $x$Ifa$ 1x$Ifx$Ifq$$Ifs4(\$ l ,4 saT V X Z  NX8$$Ifs4P$4$,4 sax$Ifq$$Ifs4h\$ l ,4 sa  ^ ~ DV^$$Ifs4PF$$ ,    4 sa $x$Ifa$x$If8$$Ifs4P$`%4 sa b f *\orzl`WCJOJQJ^J5CJOJQJ\^J5@CJOJQJ\^J5@OJQJ\^J jOJQJU^JmHnHujH OJQJU^JjOJQJU^J OJQJ^J5CJOJQJ\^J&j5OJQJU\^JmHnHuj5OJQJU\^J!j5OJQJU\^J5OJQJ\^J TNLJJJ8$$Ifs4$#X4 sa<$Ifq$$Ifs4(\<$@4  ,4 sa ` b d f {|sjjj $$Ifa$x$If~$$IflF !$06    4 la$If opqr  !` T$ !X$$Ifl$h%064 la$&P1/ =!"#$8%DText19 MMM. d, yyvDText27vDText37vDText20vDText21vDText23vDText24vDText22vDText25vDText26vDText28vDText29vDText30vDText31vDText32vDText32tDeCheck1tDeCheck2vDText35vDText39vDText32 i0@0 Normal_HmH sH tH D@D Heading 1$$@&a$5OJQJ\^JHH Heading 2 $x@&56OJQJ\]^JF@F Heading 3 $x@&5CJOJQJ\^J<A@< Default Paragraph Font6>@6 Title$a$5OJQJ\^J6J6 Subtitle5OJQJ\^J0@0 TOC 15OJQJ\^J44 TOC 2 <<5\,@2, Header  !, @B, Footer  !r: zrFGHYZl18abi}]^k 012345IJKLMNO[/?STUVWXYmnopqrstuvos0000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 0@0ZZZ]Tb r ,V ` j T  r q lx~)/9EIMY_iu{kw}(.5AG[kq?KQYekrFFtFFFtFtFtFtFFFFFFFFG$G$FFFText19Text27Text37Text20Text21Text23Text24Text22Text25Text26Text28Text29Text30Text31Text32Check1Check2Text39m:Njl\r@s 0J`|~/lRsl09JM`i|k~/5H?RYlpsl08JMai|k~/5H?RYlps::: jsanderson*U:\MS\MsaPubs\R077-001\fm70draftmaster.doc jsanderson*U:\MS\MsaPubs\R077-001\fm70draftmaster.doc jsanderson+U:\MS\MsaPubs\R077-001\fm70draftmaster2.doc jsanderson+U:\MS\MsaPubs\R077-001\fm70draftmaster2.doc jsandersonuC:\Documents and Settings\jsanderson.CAPNET\Application Data\Microsoft\Word\AutoRecovery save of fm70draftmaster2.asd jsanderson+U:\MS\MsaPubs\R077-001\fm70draftmaster2.doc jsandersonNU:\MS\MsaPubs\Ratification\2003 NB Aug\Aug NB Jun 20 03\PostNB\F070 Sep 03.doc jsandersonNU:\MS\MsaPubs\Ratification\2003 NB Aug\Aug NB Jun 20 03\PostNB\F070 Sep 03.doc jsandersonNU:\MS\MsaPubs\Ratification\2003 NB Aug\Aug NB Jun 20 03\PostNB\F070 Sep 03.doc jsandersonOC:\Documents and Settings\jsanderson\My Documents\Pubs_Fms\Fms Word\capf070.dotHYZl18abi}]^k 012345IJKLMNO[/?STUVWXYmnrstuvs@ y~#yyLrPPPP P P@UnknownGz Times New Roman5Symbol3& z Arial"hܳzfܳzf9r1"d20d%i2Q,VEHICLE REHABILITATION REIMBURSEMENT REQUEST jsanderson jsandersonOh+'0  4@ \ h t -VEHICLE REHABILITATION REIMBURSEMENT REQUEST9.0EHI jsandersonAsansanNormals jsandersonA2anMicrosoft Word 9.0I@@v#g@Qژ@Qژ1՜.+,0 hp  CAPNHQ% -VEHICLE REHABILITATION REIMBURSEMENT REQUEST Title  !"#$%'()*+,-./012345789:;<=?@ABCDEHRoot Entry F@ ۘJData 1Table& WordDocument&:SummaryInformation(6DocumentSummaryInformation8>CompObjjObjectPool@ ۘ@ ۘ  FMicrosoft Word Document MSWordDocWord.Document.89q