PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000400110077-2
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 4
• Document Creation Date: November 17, 2016
• Document Release Date: November 1, 1999
• Sequence Number: 77
• Publication Date: August 8, 1956
• Content Type: FORM

Standard Form No. 1084-Revised D. O. You. No_ _______________________________
Farm 3'rerlb b
C"omptrollber 7 ~t
_r
Sep roved Fo if 360R000400'~0077-2
emmber 7, 1 No. 11)
Gen ry ? SERVICES Bu. Vou. No- ---------------------------------
. Reg No. 51, SnPP.
(Amended February 2O, 1952)
U. S. -------------- o3T- R F ------------------------------------------------------------------------------ I PAID BY
t
li
h
men
)
s
'(Department, bureau, or estab
Voucher prepared at --------- ------------------------------------------------------------- ~.,.
(Give place and APC
THE UNITED STATES, Dr., Payee's Account No --
oPY, S OF 5
---------------------
----------------------------------------------------
ro - (payee)
--------------------------
------------------------------------Address) --------- --------------- ( (State)
Clty)
No. and Date of
Order
PAYMENT:
Complete ^
Partial ^
Final ^
Date of Delivery
or Service
ARTICLES OR SERVICES
supply
(Enter
schedule, and other information deemed necessary)
Discount Terms
Shipped from to
Government B/L No. I Total
I certify that the above bill is correct and just and that payment has not been received.
STATOTHR
Pursuant to in me. I certify that this account is correct and proper for payment.
(Payee must NOT use this space)
-----------------------------------------------
Amount verified; correct for -___r-_--
(Signature or initials) -------
STATOTHR
Date ------------------------------------------=------------------------------
Title ---------------------------------------------------------
THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANT FORM
STATOTH R
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown{ other classification optional)
STATOTHR
Paid by ( Check No. --- dated ---------------------------- .----------------
favor of payee named above.
--- ---------------------------------------
on 19 Payee ----------------------------- fait,, e i it i only)
Cash, -------------------
? When a voucher >~ .. e t ? n i ~ 94-00-36URQD(f400110077-2 ---------------
writing tho comps,, o
"John Doe Company, per John Smith, Secretary", or' Treasurer' as t o case may be.
tIf the ability to certify and authority to approve are combined in one person, one signature only is nec? Title _______________________________________________________
essary otherwise the approving officer will sign on the line below "Approved for $---------------------- and
r his official title.
 Approved For Release 2000/04/12 : CIA-RDP64-00360R000400110077-2
STATOTHR
Approved For Release 2000/04/12 : CIA-RDP64-00360R000400110077-2
 ~ '- proved For
Release 2000/04/12: CIA-RDP64-0036OR000400110077-2
? OK8773___..
COST CENTER
DATE
MAJ
INT
SUB
MO
DAY
YR
25
20
2 O
O7
OSi
6
25
20
20
07
12
6
2$
20
2Q
07
10
6
29
20
20
07
1 i
e
El CHE... REGISTER 11 DETAIL 1NDIRECT',_?IRIBUTION
E CHARGE DISTRIBUTION CLEARING LIST 11 SUMMARY DIRECT POSTING JOURNAL
DETAIL DIRECT DISTRIBUTION ^ SUMMARY INDIRECT POSTING JOURNAL
FOR OPERATING DIVISIONS
CHTkCK
NUMBER
9070 If
TREAS OF
U Ea
5?799
W M
RAMtC
90729
LEED
{ N S
90770
K 1 ER UL Or F
ACCOUI\
^ SUMMARY INDIRECT POST
FOR NON-OPERATING DIV
PURCHASE ORDER
OR INVOICE
NUMBER
I
I
I
U I
15:282A 12
51203 36
Approved For Release 2000/04/12 : CIA-RDP64-0036OR000400110077-2
 Approved For Release 2000/04/12 :
C CONSOLIDATED DIS'. TION REPORT
ADJUSTMENTS
ITS PAID
~pINO JOURNAL
CI SIGNS
RECEIVING
REPORT
NUMBER
C. E.
CODE
11
1 2 7 0 4
PAGE
O
1 4 4'
12700
1
1440
t 4 417'0
14 4;707
..
7223
1 27 0 0
5
024
1
2
4 20
24170
T5 Ta
12700
9
02 A
1
3
a 6"To
-
6810
is 6 ? 0
7-0 r?~~ " ~ /,/
"TE
DISTRIBUTION
AMOUNT
95050
560
5 ?5 6 0
0
3
Approved For Release 2000/04/12 : CIA-RDP64-0036OR000400110077-2
RDP64-0036OR000400110077-2