PUBLIC VOUCHER FOR PURCHASES SERVICES OTHER THAN PERSONAL

Document Type: 
Collection: 
Document Number (FOIA) /ESDN (CREST): 
CIA-RDP64-00360R000400010026-9
Release Decision: 
RIPPUB
Original Classification: 
K
Document Page Count: 
2
Document Creation Date: 
November 17, 2016
Document Release Date: 
June 29, 1999
Sequence Number: 
26
Case Number: 
Publication Date: 
June 27, 1955
Content Type: 
FORM
File: 
AttachmentSize
PDF icon CIA-RDP64-00360R000400010026-9.pdf89.58 KB
Body: 
Standard FormNo. 108y4-Revised. 1240 Oolaor oiler se neralbU. S. 'UBLIC VOUC E~~j..~~II D. o' Vou-No' .JY #~((Amen led gar Rele U 1 00400010026 aw Bu. Vou. No. U.S. _Cost__Reimbursble (Department, bureau, or establishment) PAID BY Voucher prepared at _____________________________ (Give place and date) THE UNITED STATES, Dr., Payee's Account No. ___3__43_______ To ------------------------------------------ ----------------------------------------------------- (Payee) ------------------------ (Address) (City) (Stae (State) ARTICLES OR SERVICES No. and Date of Date of Delivery (Enter description item number of contract or Federal supply Order or Service schedule, anc~ other information deemed necessary) QUANTITY Discount Terms PAYMENT: Complete ^ Partial ^ Final ^ whipped from to Weight Government B/L No. Total I certify that the above bill is correct and just and that payment has not been received. (Payee must NOT use this space) STATINTL Date --- . P Differences STATINTL 16,514 --------------- --------------- --------------- Amount verified; correct for ----------- (Signature or initials) ----------------------------------------- Pursuant to authority vested in me, I certify that this account is correct and proper for payment. f` Approved Ws ._ ~~ 1+ ?_OO JKIGINAL Title '-O . ying_Offi ONLY cer Title -QO=Itr&C __0ffi Cer - - Date ------2~r"r ------------------------------------- STATI NTL THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECUR D WITHOUT WRITTEN AGREEMENT IN ANY FORM ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown; other classification optional) APPROVED: STATINTL Approving Officer Paid by Check No- ------------------------ dated ------------------------------ 19-----, for $-------------------------------------- f on Treasurer of the United States in favor of payee named above. -------------- Cash, $---------------------- on ---------------- ---------1 19-----. Payee ---------- l (sign origl-I only) ? When a voucher is signed or receipted in the name of a company or corporation, the name of the person v rating the company or corporate r as we s t e capacity i P "John Dee Con y or . i e as 1 1o 1o43 ta~~ c'fAFRcrr6 O3&OR000-40$01-0026.9------------------- } If the abilit~tdLEiETf(f RTiCRoy~Cd p re eonincd In one person, one signature only is nec- essa ; otherwise the approving officer will sign on the line below "Approved for $------------------- ", and' nd Title _____________________________ __________________________ over is oIIlcisl title, Standard Form No. 1086-Revised Cc ormpresedbed for Release 0Y qhexI Ft[ 400010026-9 1(den. Reg. No. 81, 8upp. No. 11) `'Services Other Than Person CONTINUATION SHEET U. S. __~=ost Reimbursable- ----------------------------------------------- Sheet No. ----] ------ of Bureau Voucher No. _25. ------- -------------------- (Department, bureau, or establishment) No. and Date of Order ARTICLES OR SERVICES (Enter description, Item number of contract or Federal supply schedule, and other information deemed necessary) 6-12-55. Contract A101 for the period 6-6-55 thru Direct Labor Costs properly chargeable to SYSTEM 1 CONFIDENTIAL PAYROLL Approved For Release 2000/04Eo4B1Ma5CJA RDP64, 360R0