PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000400100043-0
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 10
• Document Creation Date: November 17, 2016
• Document Release Date: December 16, 1999
• Sequence Number: 43
• Publication Date: July 12, 1956
• Content Type: FORM

Payee's Account No. _-116__---
lal.etidarc} 'Orm.rro. a r
ene bc~ b P y V- ^^
ilr m prello(s3crl oved For ~ rAWs9~J,
Coml:'roJ~ ~/g /R, j~1~.-,, -~y,1360R00040031~D043-0
September 7, 19 Bu. Vou. No- --------------------------------
((ien. Reg. No. bl, Supp. 1961) ...SERVICES 0TH Il
(Amended February 2o,
- ---------- ----------------
U. s. --OST RE --------- --------------------------------
,(Department, bureau, or establishment)
Voucher prepared at -----------------------------------------(-- (l - -ive-place---------and-date- --- ) --. ---------------
THE UNITED STATES, Dr.,
-----------------------------------------------------------------------------------------------------
Tv (Payee)
----------------------------------
-----------------
(A ------------ ) (State)
City
ddress ( ~ i
No. and Date of
Order
PAYMENT-
Complete ^
Partial ^
Final ^
Shipped from
Date of Delivery
or Service
ARTICLES OR SERVICES
supply
(Enter sc edule, and other information deemed necessary)
Discount Terms
STATINTL
72
COPY ~ OF
Government B/L No. I Total?
I certify that the above bill is correct and just and that payment has not been received.
(Payee must NOT use this space) ,
0.9598
Y
---------------
---------------
---------------
---------------
Amount verified; correc for _ ---------
(Signature or initials) - -- ---------------------------------
Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
VXZAJsMM STATINTL
Date --------------------------------------------------------------------------
Title --------------------------------------------------- -----
THE REVERSE OF THIS FORM MUST RE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown; other classification optional)
STATINTL
,APPROVING OFFICER
Check No. _ ______ dated ------------------------------ 19----- ,for $--------------------------------------- on Treasurer of the United States in
{ favor of payee named above.
Paid by Cash, $ ------------------------, on ------- ----------- 19 ----- Payee ----------------- ------------------------------
*When a vouchert~f , fah n~p~gf,s} g$ Q
writing the company o?l!d>~ a' W ?" ~s ltliar&I Cfi EJ h ~Ip 1C fl ? a =0D 36~RD~0 00100043-0
' John Doe Company, per John smith, Secretary", or "Treasurer as t c case may o.
Title -------------------------------------------------------
11f the ability to certify and authority to aPprovo are combined in one person, one signature only is nec
essary; otherwise the approving off oor will sign on the line below "Approved for $------------------- , and
..~nr his official title.
 Standard Form No. 1016a-Revised
Form pre,y~rj~
Go For Ret
mptroiler/l~l#~.ed eYAu61'(JF14 OR00040R D1M
8eptembar 7 111950
(Gen. Reg. No. 51, 9upp. No. 11) Services Other Than Persona
CONTINUATION SHEET
t'ro$7" REIN er M ---------------------------------------------- Sheet No. --1 -------- of Bureau Voucher No.
(Department, bureau, or establishment)
Date of
ARTICLES OR SERVICES
QUAN-
UNIT PRICE
AMOUNT
of Order and Date
Delivery
(Enter description, Item number of contract or Federal supply schedule
TITY
TITY
or Service
and other information deemed necessary)
Cost
Per
Dollars
Cts.
Contract A101 as System III
Direct Costs Properly Chargeable to-
Contract A1.01 for the period. 6/11/56
thra 6/17/56
TATIN
L
Labor Week Wing Jttne 17, 1956
4T I N T L
Ov6ih6ad ac uteri for Cc_ i+ea C>
3100-_
9:0 0
2 0100
2 000
20100
2 000
Approved For Release 2000/04/11 : CIA-RDP64-0036OR000400100043-0
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DISTRIBUTION
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