PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000400020001-5
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 2
• Document Creation Date: November 17, 2016
• Document Release Date: December 15, 1999
• Sequence Number: 1
• Publication Date: August 23, 1957
• Content Type: FORM

Sta.'.Llu F rm No. 1084-Revised
f drm prescribed by p
?01 for Rele
(Gen. Re . No, 51, 9upp. No. 11)
(Amended February 20, 1952)
U. S. __Cost Reimbursable-
- --------------------------------------------------
(Department, bureau, or establishment)
Voucher prepared at -----------------------------------------------------------------------------------
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No.. 267 ......-.
To -----------------------------------------------------------------------------------------------------------------------------------
(Payee)
D. O. Vou. No- -------------------------------
00400020001-5
Bu. Vou. No. ---------11 --------------------
No. and Data of
Date of Delivery
ARTICLES OR SERVICES
(Enter description item number of contract or Federal supply
UANTITY
UNIT PRICE
AMOUNT
O
d
or Service
and other information doomed necessary)
schedule
Q
r
er
,
Cost
Per
Dollars
Cts.
Discount Terms
Cost
7,390
99
r
PAYMENT:
Complete ^
Partial ^
Final ^
Use continuation sheet(s) if necessary
Shipped from to Weight Government $/L No.
Total
7,3 0
99
(Payee must NOT use t6 space)
1 certify that the above bill is correct and just and that payment has not been received.
-----------------------------------------------
---------------
-----
---------------
for ----------
---------------
-----
Title Special Assistant to the Director
for Planning and Coordination/Approving
Officer
( Check No- ------------------------ dated ------------------------------ 19-----, for $-------------------------------------- { on Treasurer of the United States in
Paid by l favor of payee named above.
Cash. $------------------------- on ------------------------------------r 19------ Payee ----------------------------- -------orl[I--nal-----only) ------------
_ iekn
" When -a voucher is signed or receipted in the name of a company or cor )oration, the name of the person
Per ---------- -------------------?--------------------------------
Jon gDoYi hfb8`"'`~een'=1~[~~$p't~ 3608000400020001-5
}If the abi ity to cert fy and authority to approve are combined in one person,'one signature only is nec- Title ...................
,essa ; otherwise the approving officer will sign on the line below "Appruved for $------------------- , and
over his official title. ie-szeoo-5
 F N 1035-Revised
rin
d
o
N tanda
Form prescribed -1
cAp"Ve or Rele bD/Y4Mfht1A9 [ ' bg? 400020001-5
e em or
((ten. Reg. No. 51, Supp. No. 11) Services Other Than Persona
CONTINUATION SHEET
U. S. ---------------------------------------------------------- Sheet No. -----I---- of Bureau Voucher No. -11 -------
(Department, bureau, or establishment)
Date of
ARTICLES OR SERVICES
QUAN-
UNIT
PRICE
AMOUNT
No. and Date
of Order
Delivery
or Service
(Enter description, item number of contract or Federal supply schedule,
and other information deemed necessary)
TITY
TY
Cost
Per
Dollars
Cts.
CONFIDENTIAL PAYROLL_
irect Labor Cost properly chargeable
o Contract A101 for the period 3/21/55
hru 3/27/55.
eek Ending 3/27/55.
3,079
58
TATOTH
41311
41
7,390
99
S
pprove or Release 00/04/51515EONCIARDR69~0 360R000400020001-5