PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000400110035-8
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 2
• Document Creation Date: November 17, 2016
• Document Release Date: November 1, 1999
• Sequence Number: 35
• Publication Date: October 2, 1956
• Content Type: FORM

Coro troller Genera U. S.
September 1 ved Fo MOR
(C~cn. Iteg. No.. 51, Supp. 1 )
10360R000400' '035-8
U . S . _?---?---------------------- COST RE R LE
??-------------------------------------------------------------------
(JDepartment,,bureau, or establishment)
Voucher prepared at --------------------------------------------------------------------------------------------------------
(OIva place and date)
THE UNITED STATES, Dr., Payee's Account No. ------ 33---
7'0 ----------------------------------------------- -----------------------------------------------------------------------------------
(Payee)
---------------------------------------------------------------------------------------------------------------------------------
(Address) (City) (State)
No. and Date of
Date of Delivery
ARTICLES OR SERVICES
(Enter description item number of contract or Federal supply
h
QUANTITY
UNIT PRICE
AMOUNT
Order
or Service
sc
edule, an other information deemed necessary)
Discount Terms
Cost
Per
Dollars
Cts.
Costs
19,912
OE
PAYMENT-
Complete ^
Partial ^
Final ^
Use continuation sheet(s) if necessary
Shipped from to Weight Government
B/L No.
Total
y
I certify that the above bill is correct and just and that payment has not been received.
(Payee must NOT use this space)
TATOTH
Differences ---------------------------------
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Date ---_
_
Amount verified; correct for
1?'
?~
SIGN
ORIGINAL
/~~ ONLY
'
yka
(Signature or initials) _______ ----------------------------
Date Invoice Rec'd.
/a Date --------------------------------------------------
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown; other classification optional)
Check No- ________________________ dated ------------------------------ 14_____, for $______________________________________ on Treasurer of the United States in
Paid by j Cash, $ on 19 Payee . favor of payee named above.
t -----------------------------
..v+aY...aw,..s...~+.>~.,:,. (Sign original only) ----------
" When a voucher is signed or rcceipted in the name of a com O0J any or cor oration the name of the ,:=.rson
wcltingthecompanyoreorp s ~q s (~ (y l ore(sl. p~p~+~f }~~t,f e~
'John ioe Company per ~ 1c y~M r u ~L~ie 1>ti ll~. r~ "' LJr VsF-~0~6 OV VsF~~ ~~
If the ability to certify and aut ority to a prove are combined iu ono person, one sgnature only is nee- Title -------------------------------------------------------
..t sary; otherwise the approving officer will s gn on the line below "Approved for $______.____________", and
Over his otiicial title.
 Approved For Release 2000/04/12 : CIA-RDP64-00360R000400110035-8
STATOTHR
Approved For Release 2000/04/12 : CIA-RDP64-00360R000400110035-8