PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000400090017-1
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 3
• Document Creation Date: December 12, 2016
• Document Release Date: March 8, 2002
• Sequence Number: 17
• Publication Date: June 14, 1956
• Content Type: FORM

.d', . +rd Form No. 1$34-Revived ES ND
Form prescribed by VO
8
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1
a0~4g0~0~0017-1 2
360R0~~~
Oom Pt~lbeGeneral, u. f3Approv F
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fr3- 'R.rn No. 51. 9urm. No. 11) SERVICE -
U. S. __ PAID BY
OST TMBURS~BLE_ ___-------
C
-------------- RE
or establishment)
tment bureau
,
(Depar
, ------ --------- -----
Voucher prepared at _________________ (Give place and date)
THE UNITED STATES, Dr., Payee's Account No.
------------------------------------------------------------ -
TO _ (Payee)
SAPC g S
COPY OlaL:~
-----'-----------------------------------
--------------------------
(Address) (City) (State)
ARTICLES OR SERVICES UNIT PRICE AMOUNT
d ,,em Cts.
necessary) supply QUANTITY Coat Per
No. and Date of Date of Delivery s (Enter descrlptlonanItem number of contract or Federal
chedule, I I I
Order or Service
Discount Terms
PAYMENT:
Complete ^
Partial ^
Final ^ Use continuation sheet(s) if necessary Total
to Weight Government B/L No.
Shipped from 1 1 1 W s space)
I certify that the above bill is correct and just and that payment has not been received. Differences -------------------------------
STATINTL
12,,x+79
12,E+7g
---------------
---------------
---------------
---------- ---
lorbillet - 7
_____-
Amount verified; correct for .....
(Signature or initials)'__ W -----------------------------------
Date Invoice Recd.
l:ontract rw.
::::::; certify that this account is correct and proper for paymenSTATINTL
ing cer)
ertit
for $ -..;=----~--~ ~ ~ ------~ -
- SIGN
ORIGINAL Title __________________ -----------------------------------------------------
By _1 I ONLY CTATIMITI
Date ------------?-----------------------------------------
Title -
SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
ES
THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVIC
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown, other classification optional)
STATINTL
NTRAC NG 0 Cry
T1 TIM
- _f on Treasurer of the United States in
----------------- - - -- - - l favor of payee named above..
Check No. _---------------- dated --------------- 19--_--,for $------------------------------
19------ Payee slrn or em.l odr)
Paid by
Cash, $------- ---------- on _--?--------------------------
' When a voucher is signs e I t na of company or corporation, the name or the person Per -----------------------------------------'-- ---""_""
writing thecompany orcorp r` + 113e''g~ ' S~i ~b' FAFI ' = 0360R000400090017-1
Title -------------------------------------------------------
ohn Doe Company, per John Smith, Secretary", or' re er , a
in one person, 'one signaturo only is and
t If the ability to certify and authority to approve are combined
essary, otherwise the approving officer will sign on the line below "Approved for $--------------------
his official title. 16-.42900-5
(Sign original only)
 STATINTL
Approved For Release 2002/06/10 : CIA-RDP64-0036OR000400090017-1
Approved For Release 2002/06/10 : CIA-RDP64-0036OR000400090017-1
 CJ
MO
05
CHECK
NUMBER
tAID I
A4proved For Release 20021061*) : CIA-RDP64-0036OR000400090017-1
ACCOUNT-S-_PAI-D -REPORT'S
Approved For Rele~
PURCHASE ORDER
OR INVOICE
NUMBER
517604
517600
5:104 2 1
r1 7 3_ s_..
se !2002106110
RECEIVING
REPORT
NUMBER
2 2 4 4 0
C. E.
CODE
12700
12700
..t_2700
5 12700
12700
DATE
REPORT NO.
DISTRIBUTION
AMOUNT
1 9;0 0
19100
1900
1900
76'35
7 6:3 5
7635
76135
a 6 115 8
8 6--l 15.8
861 8
86 158
...6193 6;53
6'93
6;9 3
3 215 0
32,50
3 2;5 0
3'95 0_.
1 4174
1 4 7 4
1474
1 4;74
`788'00
`$8100-
5 8 8100
S88:0a
648
6i4 8
6:4 8
6,4 45