PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000400110070-9
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 4
• Document Creation Date: November 17, 2016
• Document Release Date: November 1, 1999
• Sequence Number: 70
• Publication Date: August 17, 1956
• Content Type: FORM

l9t&ndn Form]~~s gibed b4-Revised
D. O. Vou. No. -
C.omptro- ~c> o eFd For RdAeMLIMNO U 'aP $ R000400110070-
Septem , 1
(Con. Reg. No. 51, Supp. No. 11)
1) SERVICES OTHER THAN PERSONAL Bu. You. No. ------ 7
---------------------------
O5
Shipped from to Weight Government B/L No. Total
I certify that the above bill is correct and just and that payment has not been received. (Payee must NOT use this space)
STATOTHR
A
----------------------------------------------- --------------- -----
Amount verified; correct for ----------- - 499,90
Per _____I (Signature or initials) _____________
)
(Amended February 20,
U. S COST RE SART.11:
(Department, bureau, or establishment)
Voucher prepared at ------------?-------------------------------------------------------------------------------------------
THE UNITED STATES, Dr., Payee's Account No.
TO -----------------------------------------------------------------------------------------------------------------------------------
(Payee)
----------------------------------------------------------------------------------------------------------------------------------------
(Address) (City) (State)
No. and Data of
Data of Delivery
ARTICLES OR SERVICES
(Enter description Item number of contract or Federal supply
d
UANTITY
Q
UNIT PRICE
AMOUNT
Order
or Service
schedule, an
other information deemed necessary)
Discount Terms
Cost
Per
Dollars
Cts.
Coats
13,300
53
PAYMENT:
Complete F]
Partial ^
Final El
Use continuation sheet(s) if necessary
1.3 0
53
Differences ---------------------------------
-----------------------------------------------
---------------
---------------
-----
-----
_
----------=------------------------------
---------------
-----
Contract No. .A1,01 Date Req. No. Date Invoice Rec'd.
Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
t Approved for $ -----------------------------------
By ------------------------------------------------------------
Title ----------------------------------------------------------
SIGN
ORIGINAL
ONLY
STATOTHF
Date --------------------------------------------------------------------------
THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
ACCOUNTING CLASSIFICATION (Appropriation Sym must be shown; other classification optional)
STATOTHR
* When a vouc r C O M p t a"al p-a mustt ho n o
writing the compan r orporate name, as well as the capacity in which he s gns, appear. For example:
"John Doe Company, per John Smith, Secretary", or "Treasurer", as the ease may be,
t If 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
I CChasech. k $ No- ____________________ ? ___ on _ dated ___-___________-___ -_________, ? 19 19 _____, for $-- P----ayee -_________ --__-__________________ on Treasurer of the United States in
Paid by . favor of payee named above.
--- --- ------ -- ---- -------
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ep0360R00040011O070-9 ---
Title -------------------------------------------------------
 Approved For Release 2000/04/12 : CIA-RDP64-00360R000400110070-9
STATOTHR
Approved For Release 2000/04/12 : CIA-RDP64-00360R000400110070-9
 Rw - T p WRTT CHECK REGISTER DETAIL INDiREC1 fRIBUTION
ACCOU
Approved For Release 2000/04/12 : CIA-RDP64-0036OR000400110070-9
INT
+~__ ^ SUMMARY INDIRECT POSTING JOURNAL
FOR 0PE
ETAIL DIRECT DISTRIBUTION DIVISIONS
MO
0 T
DAY
~
CHECK
NUMI*3
`J u
^ SUMMARY INDIRECT POS
FOR NON-OPERATING DI
PURCHASE ORDER
OR INVOICE
NUMBER
Approved For Release 2000/04/12 : CIA-RDP64-00360R000400110070-9
 Approved,or Release 2000/04/12 : CIADP64-00360R000400110070-9
ITS PAID
STING JOURNAL
RECEIVING
REPORT
NUMBER
C. E.
CODE
CONSOLIDATED 6ISTRIB?U7I0N REPORT -- -
^ ADJUSTMENTS
M.J.O.
WORK ORDER
DATE
REPORT NO.
DISTRIBUTION
AMOUNT
Approved For Release 2000/04/12 : CIA-RDP64-0036OR000400110070-9