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Tj 1.443 -24.72 Td (I have not accepted an honorarium or expense reimbursement from more than five institutions within) Tj -0.96 -10.08 Td 108 Tz (the previous six months.) Tj /F0 10 Tf -38.044 -37.358 Td 91 Tz (I certify that the information contained on this form is to the best of my knowledge and belief, true and complete.) Tj ET 2 J 36.009 144.825 383.04 29.52 re S 2 J 419.049 144.825 158.4 29.52 re S BT /F1 8 Tf 423.128 164.735 Td 115 Tz (Date) Tj -383.278 0 Td (Payee's Signature) Tj /F3 10 Tf -2.177 -44.507 Td 98 Tz (Instructions for Accounting Office. Review this form and the Travel Expense Voucher \(UM 11\) to determine that payment to the) Tj 0 -12.48 Td 111 Tz (payee adheres to University policies. Indicate your approval on the Travel Expense Voucher. Process reimbursement) Tj 0.238 -11.999 Td 106 Tz (of travel and incidental expenses under the accountable plan in accounts payable. 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