PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000400060014-7
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 2
• Document Creation Date: November 11, 2016
• Document Release Date: April 22, 1999
• Sequence Number: 14
• Publication Date: December 20, 1955
• Content Type: FORM

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Comptroller Cieueral, U. S.
(Gen. Re No, 21, supp No. 11) SERVICES OTHER THAN PERSONAS Bu. Vou. No. -------------- 123_____________
(Amended February 20, 1952)
U. U.S. ------------------------------- Cost-Reimbursable
-- ------------------------------------
(Department, bureau, or establishment)
Voucher prepared at ----------------------------------- ---------------- -----------------------
(Clive place and date)
THE UNITED STATES, Dr., Payee's Account No. ----- 59Q ----
TO --------------------------------------------------------------- -
(Payee)
ARTICLES OR SERVICES
UNIT PRICE
AMOUNT
No. and Date of
Date of Delivery
(Enter description Item number of contract or Federal supply
UANTITY
Order
or Service
schedule, and other information deemed necessary)
Q
Discount Terms
Cost
Per
Dollars
Cts.
Cast
3,196.
9E
PAYMENT:
Complete ^
Partial ^
Final ^
Use continuation sheet(s) if necessary
Shipped from to Weight Government B/L No.
Total
3,196.
(Payee must NOT use this space)
I certify that the above bill is correct and just and that payment has not been received.
Differences --------------------------------
---------------
-----
STATI NTL (Sign original only)
------------------------------------------ I
---------------
-----
Date - 11-2a-55 * The -WO
----------------------------------------------
-----------------------------------------------
---------------
-----
Amount verified; cor
or -----------
1
6.9-6 ---------------
STATINTL
0 IGN L Title ---- ----------
ONLY
Titl ---- Gontracting-_Offioe '----------------
STATI NTL Date --------------------------------------------------------------------------
THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
APPROVED:
STATINTL
Check No_ ------------------------- dated ----------------------------- , 19 ------ for $-------------------------------------- 1 on Treasurer of the United States in
Paid by j l favor of payee named above.
t Cash, $----------------------- on ------------------------------------- 19-----. Payee --------------------------- ------ -----------
--------------------------
ieian oriefnct only)
.When a voucher is signed or receipted in the name of a company or corporation, the name of the person Per ---------------------
writing the company or corporate name, as well as the capacity in which ho signs, must appear. For example: ---______"""'__________________?'"_?----
"John Doe Company, per John Smith, Secretary", or ` Treasurer", as the case may be.
tIf the ability to certify a ror n r opl e-
essarY; otherwise the approsg i ' ~ ' f P ~_. IAA DP64L00-36OR00040046001417.2---- 5
d
(Signature or initials) ---------------------------------
nvoice Rec'd.
 MandarsT Form No. 1036-Revised
comptroller Ge era'S.anitized - A 31 r~cPR f~'e 's~' 1~6 ~0360R000400060014-7
Form
September 7, 1950
(Gen. Reg, No. 51, Supp. No. 11)
Services Other Than Person
CONTINUATION SHEET
U. S. ------------------------ CQs - .e bur &b ..e::: -------,----------------------------- Sheet No. ----1------ of Bureau Voucher No. -123-
of
Date
ARTICLES OR SERVICES
QUAN-
UNIT PRICE
AMOUNT
No. and Date
Delivery
(Enter description, item number of contract or Federal supply schedule.
TITY
of Order
or Service
and other information deemed necessary)
Cost
Per
Dollars
Cts.
PAYROLL SYSM -IV
Direct Labor Costs properly changeable to
Contract A 101
TATIN
L
for the period 11/7/55 through 11/13/55
Week ending 11/13/55 STATIN
L
Overhead computed at interim rate
Total Labor and Overhead
3-196.
6:~
Sanitized - Approvedu.Fors1e1ease-c! OFA DP64-0036OR000400060014-7