PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000400110036-7
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 2
• Document Creation Date: November 17, 2016
• Document Release Date: November 1, 1999
• Sequence Number: 36
• Publication Date: October 2, 1956
• Content Type: FORM

For-' preserloca b
Comptrilor Genera
September 7, 19f1A FJroved Fo~ 1 (G(Amonen. February 20, 1952)1)
U..S. ------- COST P EIMB JR LE
(Department, bureau, or establishment)
Voucher prepared at ------------------------------------------------------------------------------------------------- ------
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No. ---134-0
-------
TO -----------------------------------------------------------------------------------------------
(Payee)
----------------------------------------------------------------------------------------------------------------------------------------
(Address) (City) _ (State)
Sl1?C ~tD
COPY r 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
or Service
schedule, and other Information deemed necessary)
Discount Terms
Q
Q
Cost
Per
Dollars
Cts.
Costs
8, 615
76
PAYMENT:
Complete ^
Partial ^
Final ^
Use continuation sheet(s) if, necessary
Shipped from to Weight Government B/L No.
Tota
l
I certify that the above bill is correct and just and that payment ha'a not been received.
(Payee must NOT use this space)
TATOTH
Differences ---------------------------------
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8
1
5
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-
'
-
Date --
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-----
~;,
A#mount verified; correct for
0360R000400110Q-7
Bu. Vou. No- ------------ ------------------
S
(Signature or initials) ----- _________________________
STATOTHR
STATOTH FgHE REVERSETF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
I Check No- ________________________ dated _______________-___---___-_--, 19_____, for $__________________________-____-______ on Treasurer of the United States in
Paid by . Ifavor of payee named above.
Cash, $ on 19 Payee -------- ------ ------- --- ---
(Sign o iglnnl only)
? When a voucher is signs orr~re[cceiiptetedin the me ofryAe~(c~o~ pany or swot o o We f th 1p~Pn ~1 /~1R f -AAAI~ .4 s~~ ~e
writing the CompayoreorpJoVAlhl3,'3e e r r'Prerli; r r ,11The a O~ o. ~64-V V3 RV V VaFV V 1 1-0036-/
"John Doe Company, pe
t11 the ability to certify and authority to approve are combined in one person, one signature only is nee- Title ______________________
essary; otherwise the approving officer will sign on the line below "Approved for $------ --------------- and
over his official title.
 Approved For Release 2000/04/12 : CIA-RDP64-00360R000400110036-7
STATOTHR
Approved For Release 2000/04/12 : CIA-RDP64-00360R000400110036-7