PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000400090052-2
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 3
• Document Creation Date: December 12, 2016
• Document Release Date: March 8, 2002
• Sequence Number: 52
• Publication Date: May 28, 1956
• Content Type: FORM

Form prescribed b WC UCH HER
FOR PURCHASES AI'1D
Comptroller Ge7e 96,46broved For a R0004 0 2-2 2614-
(
durd Form No. 1034-Revised D. O. Vou. No- -------------------------------
R
g. c.61, Cupp. No. JI) ,ae u. ou. o- ---------------------------------
(Glen. (Qen. Re
(Amended February 20, 1952)
COST REIMBURSABLE
U. S..-------------------- -------------------- --------------------
(Department, bureau, or establishment)
Voucher prepared at ----------ai----1------d date) ----------------------------------------
an
c
THE UNITED STATES, Dr.,
( ve p a
e
Payee's Account No. 1917--_-_--
----------------------------: --------------------------
(Payee)
-----------------
(Address) (City) (state)
No. and Date of
Order
Date of Delivery
or Service
ARTICLES OR SERVICES
supply
an, oItern ther inmfober of contract or Federal
(Entesrcdescrheduiti
deemed necessary)
Discount Terms
PAYMENT:
Complete ^
Partial ^
Final ^ Use continuation sheet(s) if necessary
Shipped from to Weight Government B/L No. Total
I (Payee must NOT use this space)
I certify that the above bill is correct and just and that payment has not been received.
Pursuant to aut}Mty vested in me, I certify that this account is correct and proper for payment)
11,63
31
95
9,
-------------------------------------------- --
Amount verified; correct for
(Signature or initials _______C_~----------------------
Date
Title ---------------------------------------------------------- STATINTL Date --------------------------------------------------------------------------
THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown; other classification optional)
Approving Officer
STATINTL
Check No - ------------------------ dated ------------------------------ I 19 ------ for $...................................... - { on Treasurer of the United States in
favor of payee named above.
ai ---------- ---
__. _, 19 ------ Payee -------------------------------- ielrn onilnd only)
When a voucher Is signed ~or, ~receipted in the ~namep of a company ~or corporation, the name of the person Per _________________________________________________________
writing thecompany orcer'~dbri in
t 360R000400090052-2
"John Doe Company, ) i cfet4ltYt F' ai efYAdM Yb? ;>fA-
If the ability to certify and authority to approve are combined In one person, one signature only is nec- Title ___________________________________________ ___________
essig otherwise the approving officer will sign on the line below "Approved for $______.____________", and 16-22e00-5
ever his official title.
 STATINTL
L Approved For Release 2002/06/10 : CIA-RDP64-0036OR000400090052-2
Approved For Release 2002/06/10 : CIA-RDP64-0036OR000400090052-2
 LJ
Approv d For Release 20021061: CIA-RDP64-0036OR0004000900 2-2
I,&CCOUNTS PAID REPORTS
DIVISIONAL SUMMARY ACCOUNTS PAID JOURNAL
^ CONSOLIDATED ACCOUNTS PAID DISTRIBUTION
CHECK
OR INVOICE
REPORT
NUMBER
NUMBER
NUMBER
25
00
00
04
24392
P I C 0
5 1 7-558
22011
25
00
00
04
6
24404
UTE) RAI) 1 0
5110944
221 58
25
00
00
04
6
24-412
TEXAS
5-'mil -7 6 5-1-
..20._8.2 7
25
00
00
04
16
6
24031
E4/C MACH
15i 1 0 0 7 3
12214
25
00
00
04
16
6
24094
THERM/O/N
5'17417
23396
25
00
00
04
16
6
24094
THERM/O/N
117417
21:562
25
00
00
04
18-
45-
-2.4..1 0.2
.-..
WRN STAMP
-2 -1-9
25
00
00
04
17
6
24254
TEMPO STAR
5110726
16865
25
00
00
04
17
6
24254
TEMPO STAMP
5110726
25
00
00
04
17
6
24291
HOLLY RA01O
5:12660
25
00
00-
..04
16
6-
24353
ORN_SO-N
5T1-0 1 50-
25
00
00
04
18
6
24353
DORNSON
5 1 0 1 so
25
00
PO
04
16
6
241 13
MAQ/ELCC
5:10930
219
25
00
0
04
17
6
2422 1
MALLORY
5117873
216
25
00
"0
04
17
6
24221.
MALLORY
t5-I-1 .7 6-7 3-
2-1--a-
25
00
0 0
0
04
16
24342
BRUSAKfi R
5:1 "7 4 3 9
219
25
00
00
04
19
6
24378
K1EtULFFF
5;17602
221'93
25
00
00
04
19
6
24379
LEACH
Ei71347
1464
2-'.5
0-0
00
0 4
fig
6-
243.9.6.
R.AVC
1 7-5-9.
.2-.-3 7
25
00
00
04
16
6
?4081
POLY TECH
517473
22000
25
00
0.0
04
16
6
24116
MAT FAS
5;17566
20710
25
00
:0
04
17
6
24213
K E A R F 0 T T
517608
20404
0--
1-2-7-00---
12700
12700
12700
12700
.27 0 0-
12700
12700
1 2700
5041
5041
5041
$041
5041
5-c.-a4-.1
5041
5041
5041
5 0-4---t 5041
5041
5041
-5-0-4-
5041
5041
5041
3
3
..-3-
3
4
4
4
4
4
DISTRIBUTION
AMOUNT
Eii4 1
014 1
8'4 1
$14 1
08;12
:00
2327
9:0 0
1800
893'51
14317
4:17
714 1
6'00
1190,00
31367:67
35367187
554140
681'12
-8-5' 1 4
1 0 8:5 7
1429123
1429'23
114 2 9:2.3
~8 8
152194
1330100
2 2i 1 0
320,98
!90808
190608
1906;08
Approved For Rele~
1 2700
12700
2-7 0-0-
2700
77-00--
2700
27 00
se'2002/06/10 :1 CIA-RDP64-6036
0