123 RCACS
1234
Commanding Officer, Admin Officer, Training Officer, etc.
Bloggins, J. E.
Only distances between 33-100 km are eligible for TA
I hereby certify that I have commuted between my residence and worksite on the days that I was required to report for duty and so reported, as indicated below, and that the kilometres claimed herein are correct and have not been previously claimed.
Initials, Surname, Rank