
JUDGE Name: Address: City & State: Social Security or Federal ID No: FOR DIVISION USE Fund: 10340 Agency: Supreme Court Appropriation Name: Senior Judge Privacy Notice: Your Social Security of Federal ID No. is requested by the Auditor of State in compliance with Federal IRS requirements (IC 4-1-8). Object Amount (Travel from Reverse Side) Meals $ TOTAL PER DIEM: $ Mileage $ FOR DIVISION USE $ Reimbursable Expenses (Paid for Travel) (from reverse side) Total $ Pay Period Ending:.
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How to fill out the IN TCS-AR5(B)-1 online
Filling out the IN TCS-AR5(B)-1 form is essential for senior judges to claim services rendered. This guide provides a clear and supportive approach to help users complete the form accurately and efficiently.
Follow the steps to successfully complete the form.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Fill in the section for the senior judge's name, address, city, state, and social security or federal ID number at the top of the form. Ensure accuracy as this information is critical for processing your claim.
- In the 'Period Covered' section, indicate the start and end dates of your service period as a senior judge.
- List each date served along with the length of service in the 'Date & Length of Service' section. Include fractional days rounded down to the last whole tenth of a day where applicable.
- If you have applicable travel expenses, fill in the 'Travel Between Points' section with the details of your travel, including mileage and any reimbursable expenses.
- Complete the 'Meals' section by indicating if your service lasted more than 12 hours or involved overnight travel. Only record expenses if applicable.
- Sum up all relevant totals for days served, mileage, meals, and other reimbursable expenses in the 'TOTALS' section. Ensure all calculations are correctly processed.
- Review all filled information to check for accuracy and completeness. Attach any required original receipts for claimed expenses.
- Complete the 'Division's Certification' and 'Claimant's Certification' sections with the appropriate signatures and dates, confirming the validity of your claims.
- Finally, save your changes, download the completed form, and keep a copy for your records. Print or share the form as needed.
Complete and submit your IN TCS-AR5(B)-1 form online today to ensure timely processing of your claim.
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