APHIS 89 Report of Reimbursable Overtime for Inspection and Quara

CLEAR FORM
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it
displays a valid OMB control number. The valid OMB control number for this information collection is 0579-0055. The time required to complete this information collection
is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and reviewing the collection of information.

OMB Approved
0579-0055
EXP: XX/XXXX

1. SERIAL NO.

UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE (APHIS)

Generate Serial Number

REPORT OF REIMBURSABLE OVERTIME (ROT)
FOR INSPECTION AND QUARANTINE SERVICE
SECTION I – APHIS SUBMITTING OFFICE
2. ADDRESS (Include Zip Code)

3. TELEPHONE NO.
(Include Area Code)

4. LOCATION CODE

5. APHIS FORM 89 TO BE DELETED OR REPLACED
(Enter Serial No.)

SECTION II – SERVICE REQUEST
6. CUSTOMER NAME

7. CUSTOMER ADDRESS

9. CUSTOMER NUMBER

8. CUSTOMER TELEPHONE NO.
(Include Area Code)

10. LOCATION OF SERVICE

11. SERVICE REQUESTED

12. SERVICE CODE

SECTION III – REPORT OF WORK
13. CURRENT OVERTIME (O/T) RATES PER HOUR

(AUTHORITY: 7 U.S.C. §§ 7701-7786, and 8301-8317; 7 CFR PART 354)

Aircraft, Commercial
Aircraft, Military
14. DATE OF SERVICE
(MM/DD/YY)

a. COMMUTED TRAVEL TIME (CTT)

Aircraft, Private

$0

($25 Maximum)

b. REGULAR (REG) O/T

(Monday – Saturday and Holiday)

$0

$0

Other
15. OFFICER NAME

16. SERVICE IDENTIFIER

17. WORK TIME

(Customs Entry No., Air Waybill No., Bill of Lading No. (Ocean, Truck, Rail), (Military Hours)
Container No., Flight No., Aircraft Tail No., and other identifier relating to the A minimum 2-hr call
service code)
back time may be
applied.

IN
(a)
DESCRIPTION

2-hr Min O/T

(b)
DESCRIPTION

2-hr Min O/T

(c)
DESCRIPTION

2-hr Min O/T

(d)
DESCRIPTION

2-hr Min O/T

(e)
DESCRIPTION

2-hr Min O/T

(f)
DESCRIPTION

2-hr Min O/T

APHIS FORM 89
JUN 2020

c. SUNDAY (SUN) O/T

(Previous edition is obsolete.)

OUT

18. O/T HOURS

Record hours and minutes
in 15 minute increments,
and round to the nearest
15-minute increment.

CTT

REG

SUN

SECTION III continued
14. DATE OF SERVICE
(MM/DD/YY)

15. OFFICER NAME

16. SERVICE IDENTIFIER

17. WORK TIME

(Customs Entry No., Air Waybill No., Bill of Lading No. (Ocean, Truck, Rail), (Military Hours)
Container No., Flight No., Aircraft Tail No., and other identifier relating to the A minimum 2-hr call
service code)
back time may be
applied.

IN

OUT

18. O/T HOURS

Record hours and minutes
in 15 minute increments,
and round to the nearest
15-minute increment.

CTT

REG

SUN

0.00

0.00

0.00

(g)
DESCRIPTION

2-hr Min O/T

(h)
DESCRIPTION

2-hr Min O/T

(i)
DESCRIPTION

2-hr Min O/T

(j)
DESCRIPTION

2-hr Min O/T

(k)
DESCRIPTION

2-hr Min O/T

(l)
DESCRIPTION

2-hr Min O/T

(m)
DESCRIPTION

2-hr Min O/T

(n)
DESCRIPTION

2-hr Min O/T

(o)
DESCRIPTION

2-hr Min O/T

O/T HOURS TOTAL

SECTION IV – CERTIFICATION
I certify that the services recorded above were performed.
19. OFFICER NAME AND TITLE

20. SIGNATURE

21. TELEPHONE NO.

22. DATE

SECTION V – PAYMENT INFORMATION
23. AMOUNT PER
O/T CATEGORY

a. CTT O/T

b. REGULAR O/T

c. SUNDAY O/T

$ 0.00

$ 0.00

$ 0.00

(Items 13a X 18 CTT Total)

(Items 13b X 18 REG Total)

24. TOTAL AMOUNT OF REIMBURSABLE OVERTIME (Total $ amount of Items 23a through 23c)
25. METHOD OF PAYMENT
BILLING

CREDIT CARD

26. CHECK OR MONEY ORDER NO.

28. REMARKS

APHIS FORM 89 (Reverse)

CASH ON DELIVERY (COD) (Complete Items 26, 27)
27. ACCOUNTING CODE

(Items 13c X 18 SUN Total)

$ 0.00