PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL
Document Type:
Collection:
Document Number (FOIA) /ESDN (CREST):
CIA-RDP64-00360R000400100032-2
Release Decision:
RIPPUB
Original Classification:
K
Document Page Count:
2
Document Creation Date:
November 17, 2016
Document Release Date:
December 16, 1999
Sequence Number:
32
Case Number:
Publication Date:
July 12, 1956
Content Type:
FORM
File:
Attachment | Size |
---|---|
![]() | 111.14 KB |
Body:
R_ is;:rcdurc. Form. ]go. 1034-Revised
Form prescribed b
Comptroller Ucner
SepLember7 A For
( Amended February 20, 190jt)
0360R0004001 32-2
Bu. Vou. No- ---------- - - -----------------
U. .J -?------- COST jJ_ _T!-ti 3lr~ ------------------ --------------------------------------------------------------
(Department, bureau, or establishment)
Voucher prepared at --------------------------------------------------------------------------------------------------------
(Cive place and date)
28
THE UNITED STATES, Dr., Payee's Account No. __11----------
7'o
-----------------------------------------------------------------------------------------------------------------------------------
(Payee)
--------------------------------------------------------------??----- ---------------------------- -- --------------------
(Address) (City) (Mate)
sAPC 76.5 5
COPY I OF "
No. and Date of
Date of Delivery
'
ARTICLES OR SERVICES
(Enter description item number of contract or Federal supply
UANTITY
UNIT PRICE
AMOUNT
Order
ervice
or Service
schedule, and other information deemed necessary)
Q
Q
Cost
Per
Dollars
Cts.
Discount Terms
Costs
2,591
21
P
STATINTL
AYMENT:
Complete ^
Partial ^
Final ^
Use continuation sheet(s) if necessary
Shipped from
to Weight Government B/L No.
Total
(Payee must NOT use this space)
I certify that the above bill is correct and just and that payment has not been received.
Differences ---------------------------------
---------------
-----
Si ?n orl inal only)
STATINTL
-
---
--
---
-
----
-
-
-
----
-
El
~~
-----
------------
-
-
-
--
-----
-
--
-
-------
-
-----
________
ate ---
d who ill or bill,)
Amount verified; correc y,r ____ ____-_
---------------
_----
(Signature or initials);
SIGN
ORIGINAL
',? ONLY
STATINTL
STATINTL
I Check No. ________________________ dated -____________________________, 19_____, for $______________________________________ on Treasurer of the United States in
Paid by { favor of payee named above.
Cash, $----------------------- on ------------------------------------- 19-----. Payee ------------------------------- ---
? When a voucher is sig ed or receipted i th name o a company or car oration the name of t le person
writing the compan or c r~~i 1 e l~ 4 {
"John Doo Company, p6r S~~tor' ~,lfs .o~d.41 iAPR
tIf the ability to certify and authority to approve are combined in one person, one signature only is nec-
essary; otherwise the approving officer will sign on the line below "Approved for $--------------------- , and
over his official title.
(Olin ariilnrl only)
64=II036ORflOt 4DII'ItrOO37-2
Title
r.
6tar+dard Form. No. 1035ar-Rovisod
ed For R re & *1l 0 I`Au~ - R00040Q 81NDUM
=o ter 11 99
((ion. Reg. No. Ii, ~upp. No. 11) Services Otter an arsons
CONTINUATION SHEET
U. S. ----------COST--EE U. ,SABM ----------------------------------------------------- Sheet No. 1-------- of Bureau Voucher No. 297------
(Department, bureau, or establishment)
No. and Date
of Order
STATINTL
STATINTL
Date of
Delivery
or Service
ARTICLES OR SERVICES
(Enter description, iothe inforrma ion deemed necessary) supply schedule,
Contract Alol - System I
Direct Costs Properly Chargeable to
Contract A101 for the period 11/28/55
thru 12/31/55
Labor Period Ending December 31, 1955
overhead computed for Communications
Division at rate appr b Air Force
audit for year 1955 - d
Total Labor and Overhead
other Costs
CKNo.
P. 0. N
Vendor
16972
lo624
E.W. Leu Co.
16999
J.L. Barrett, Co. Cashier
1701i.6
10596-
B Noland Paper Co.
1712+
10596-
0625 Noland Paper Co.
17169
J.L. Barrett Co., Cashier
Total Other Costs
TOTAL COSTS
pp For Release 200010441^iT.5,CtA=RDP64r 00360R000400100032-2