General 369c 2026

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The document is a claim form (General Form No. 369C) for services rendered by senior judges in Indiana, approved by the State Board of Accounts in 2010. It outlines the necessary information required for reimbursement of expenses related to travel, meals, and other costs incurred while serving as a senior judge. The form includes sections for claimant and division certifications, instructions for filing claims, and guidelines on reporting service days and reimbursable expenses.

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Click ‘Get Form’ to open the general 369c in the editor.
Begin by entering your name, address, city & state, and Social Security or Federal ID number in the designated fields at the top of the form.
In the 'Service as a Senior Judge' section, specify the period covered by entering the start and end dates.
List each date served along with its length in days. Remember to round fractional days down to the last whole tenth.
If applicable, indicate any meals claimed by checking if service lasted more than 12 hours or involved overnight travel.
Complete any reimbursable expenses by attaching original receipts and filling out amounts for travel and meals.
Finally, ensure both you and your division certify the claim by signing and dating where indicated before submitting.

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