PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000400060020-0
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 2
• Document Creation Date: November 11, 2016
• Document Release Date: April 22, 1999
• Sequence Number: 20
• Publication Date: December 20, 1955
• Content Type: FORM

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No. ____-__----- 127 ______________
(Gen. Rhea No, 51, Cupp. No. 11) `SERVICES OTHER THAN PERSONAL Dom. You.
(Amended February 20, 1962)
U. S. ---------Qt.ReimbwSb1c ------------------- -- .
(Department, bureau, or establishment)
Voucher prepared at ----------------- .............. ............................................................................
(Clive place and date)
THE UNITED STATES, Dr., Payee's Account No......... 6n3..
To -----------------------------------------------------------------------------------------------------------------------------------
(payee)
No. and Date of
Order
(Address) (city) (State)
ARTICLES OR SERVICLS
Date of Delivery (Enter description item number of contract or Federal supply
or Service schedule, anJ other information deerned nocessary)
Discount Terms
PAYMENT:
Complete ^
Partial ^
Final ^
SAP0 L 9'44 7-
COPY)
Shipped from to Weight Government B/L No. I Total
STATINTL
Contract No. AIO1
Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
Amount verified; correct
(Signature or initials) .__
Date
8,326
26/'
8, 3G'
26
t Approved for ------ ,32.6.26_____________ STATINTL t --------- l_.~ _ --------------------
ying 0~ er)
j-Y"--u nl. r
.l
Title ---QQ11taatiflg_-DffiCE.T-----------------
Date --------------------------------------------------------------------------
THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
STATINTL
Check No ------------------------- dated ------------------------------ 19--..., for $-------------------------------------- t on Treasurer of the United States in
Paid by t favor of payee named above.
Cash, $------------------------- on ------------------------------------- 19------ Payee
iakn u1dn4 only)
" When a voucher is signed or recelpted in the name of a company or corporation, the name of the person
writing the company or corporate name, as well as the capacity in which be signs, must appear. For example: Per ---------------------------------- .--------------- :..............
"John Doe Company, tier Jp~~iir~g~lS Secs ary" r "Treasurer"0, e ,
tIf the ability to certify al~S tAdrcwv n ~gOn a only~l> -~ DP64-Q0.36IlROQO400!Q6f.02Q_A-
-------------------
eaear~ ; otharwiso the approviing a cep w a gn on__ t55~~11 o be ow prot ed t nn71
. to mm~.ial title. 16-22900-5
 prescr No. 1036-ltevlsea
~gFo Form
Form ibed b~+anitized p~p~jpr ur,~t ~{
Com troller General, 1, ~ Of`F`C?f"1Ze4@1 lr -1TL7
(Gen. Reg. eg. No. . 51 61, , Supp. No. 11) Services Other Than Person
0360R000400060020-0
CONTINUATION SHEET
_ _ _ __ Sheet No. ________1__ of Bureau Voucher No. --127 U. S. ____LtQ~'3~ ~1 . +w~ r +
_ --------------------------------------------------
r
e
..,, .
t
blishmentl
ep
tm
n burr
r es
a
No. and Date
of Order
STAT
ARTICLES OR SERVICES
(Enter descrtpt and Item
other information deemed necessary) pply schedule.
Direct Labor Costs properly chargeable to
Contract A101
for the period 11-13-55 thru 11-20-55
Week Ending 11-20-55 STATIN
Overhead computed at interim rate M
Total Labor, Overhead, and. Other Costs
APP ",,, P64-0036OR000400060020-0