NMB Form 1002 Rev. 2/98
National Mediation Board |
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| Board No. (PLB, SBA, Arb.): | Carrier: | ||||||||
| Division No. (1st, 2nd, 3rd, 4th): | Organization: | ||||||||
Activity days Claimed (in multiples of 1/8) |
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Month |
Day |
Year |
NMB Case Number |
Award Number |
Decision Code** |
Travel |
Hearings |
Study & Prep |
Total |
TOTAL |
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| *Certified
Correct. Payment or Credit has not been received.
DATE: ....................................................................SIGNATURE: .................................................................... |
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*False, fictitious or fraudulent claims-whoever makes or presents to any person or officer in the civil, military, or naval service of the United States, or to any department or agency thereof, any claim upon or against the United States or any department or agency thereof, knowing such claims to be false, fictitious or fraudulent, shall be fined not more than $10,000 or imprisoned not more than five years or both. June 25, 1948, C., 645, 62 State. 698 (Title U.S. Code 287)
** DECISION CODES: ST=Sustained; DN=Denied; PS=Partially Sustained; WD=Withdrawn; RM=Remanded; DS=Dismissed; PD=Party Decision.
** REASONS FOR IN=Interpretation; RA=Re-argument; ES=Executive Session;
LATE CHARGE: CR=Court Remand
- USE SEPARATE FORM FOR EACH MONTH -
Instructions for Revised Form NMB 1002
In compliance with the Paperwork Reduction Act, NMB Form 1002 has been revised. The form will be used for each Public Law Board, Special Board of Adjustment or NRAB assignment, resulting in one form being submitted for each board/division rather than each case.
You will note that separate columns are provided for hours spent in travel, hearings and study/preparation for each case handled. This format will make the form compatible with the date entry requirements of the National Mediation Board.
REMINDER: No more than one day's pay will be paid for any one date.
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