![]() |
Code of Federal Regulations (Last Updated: July 5, 2024) |
![]() |
Title 32 - National Defense |
![]() |
Subtitle A - Department of Defense |
![]() |
Chapter V - Department of the Army |
![]() |
SubChapter H - Supplies and Equipment |
![]() |
Part 625 - Surface Transportation - Administrative Vehicle Management |
Appendix A to Part 625 - Dependent Travel Waiver of Liability
Latest version.
-
Appendix A to Part 625 - Dependent Travel Waiver of Liability
“I _____________________
(Name of dependent)
will be accompanying _____,
(Name of employee)
who is my _________________
(Relationship)
and who is an employee of _____,
(Agency, division)
on official Government business in or while using a Government vehicle. Dates of travel are from _____ to _____ 19__. I do hereby knowingly, freely and voluntarily waive any right or cause of action of any kind whatsoever, against the United States, arising as a result of such activity from which any liability may or could accrue while accompanying the above employee in or while using said Government vehicle.”
Signature of dependent
Notary Public
Date
Date