PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000400100010-6
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 2
• Document Creation Date: November 17, 2016
• Document Release Date: December 16, 1999
• Sequence Number: 10
• Publication Date: July 25, 1956
• Content Type: FORM

Csidandard Form No. 1084-Revised
Fnrm nrranrihrd by
~~~,t~or Releasp~~'~`~,',~
U. S. ---------------------- ~~_ 7
- (Department, bureau, or establishment)
Voucher prepared at __________________________________?- _
-- - -------------------------------
(Ciive place and dato)
THF. UNITED STATES, Dr., Payee's Account No. ___ ~ ____
To
SAPC ~ ~c~ 'T
COPY l o~ ,~ -
---------------------------------
(Fayee)
--------------------------------
------------------------------------------
(AriArnaa\ _________________________________________________
No. end Date of
Order
Date of Delivery
or Service
ARTICLES OR SERVICES
(Enter description item number of contract or Federal supply
schedule, an~ other information deemed necessary)
Discount Terms
PAYMENT;
Complete
.Partial
Final
......,,ua.,v? o?corta~ u necessary ~
Shipped from to Wei ht
B Government B/L No. Total
I certify that the above bill is correck and just and that payment has not been received_ I (Payee must NOT use this apace)
STATINTL
Date _ STAT1 NTL
--------------------------------------------------------------------
THE REVERSE OF THIS FORM MUST BE E%ECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANT FORM
STATINTL
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be showni other claasificatian optional)
STATINTL
aP~avintG aFFic~x ~ 7 JUL i9
~iteclr 1V 0. ________________________dated _____________________________~
Paid by
19_____, for $__________
__________________________-- on Treasurer of the United States in
{
on
Cash, $----------------------
1
favor of payee named above
---
------------------------------------~
9---__. Payee --
.
---------------------------------
` When a voucher is signed or receipted in tho name of a company or cor oration the nam he ~
writing the company r cor ors o n a~v~ 1~s ry~vYA~ ~ p .a~?~~~~'~~
John Doe Compan~~~ SE~'~J9rY~~~ligr'4ds-AMc ~~,~y b~ 1 V
yIf tho ability to cer y nd sut ority to a provo are combinod in ono person, ono signature only is nec-
essary; otherwise the approv[ng ofllcer will s~gn on the line below "Approved for $______.____________ ,and
over his oiltcial title.
6~~-fl?36t~Rfl004flfl 1~}?{~~0-6----------------
Title __________
 fdtandardFp ~~~~0`~r Re~eas~e 2~0/0~/11 ? CI~; RD~64-003648000400100010-6
' ~/~m6ePt mbei7?i95ou. s. ~,, HC OL1C (',r fir lflrC 1S~S ~
(Qen. Reg. No. b1, 3upp. No. Il) ServaCes (3$her Th3x1 Persc~~~l~ I~%EM~RANDZ3Ni
CONTINUATYON SHEET ~~
~~~ ~~~~"~`~ _ ____________ She+e! Nm. ___~'_______ of Bureau Voucher No. __~`~_7_____
U. S. ---------------------------------------------------~-------------------------------_ -
(Depaitment, bureau, or establishment) ,
No. and Date
Date of
ARTICLES OR SERVICES
QU
AN-
UNIT PRICE
AMOUNT
of Order
Delivery
(Enter description, item numb?r of contraot or Federal supplg achadwEe,
~
PITY
or Service
and other information doomed necessary)
Cost
Per
llollara
Cta.
Ocntract A101 - ~yate~- TT
Direct Coasts Proper f~axgeable to
Contract Alai for the pericad 6/11/6
thzu 6/17/6
S
ATINTL
Labor t'ar the per3cxi ~~11?/56 thru
/1?f5
O~rer2~-esu~ co~putad 2'flr the ffiectroni.e
STAT
NTL
Instruna~ntatican Dttvision at int~ar3n
xate of
dotal Labor & f3verhead.
~ ~ ~ ?~ erase eaa ted at 3nter3.x rate
STATI
TL
cad
~btal Costs
10$0
~
Approved For Release 2000/04/11 :CIA-RDP64-003608000400100010-6