PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000400110090-7
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 3
• Document Creation Date: November 17, 2016
• Document Release Date: November 1, 1999
• Sequence Number: 90
• Publication Date: August 9, 1956
• Content Type: FORM

Form prescrioea ny t~~~~ ~~~ppp
E~
Coi ieptember Gen7, 1 e
S l I*oved,F Fy_ ~r[
September
(Gen.
Amended February 20, 1952)1)
t4l& D. O. V ou. No. -------------------------------
Bu. Vou. No_ ___________360R0004001100 -7
U. S. 5-M iE1L'xi?4 iMMa ----------
--------------------------------------------------------
(Department, bureau, or establishment)
Voucher prepared at --------------------------------------------------------------------------------------------------------
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No. -- ____
TO -----------------------------------------------------------------------------------------------------------------------------------
(Payee)
----------------------------------------------------------------------------------------------------------------------------------------
(Address) (City) (State)
ffffififflWARR'
SAPC `e Z &v_3
COPY I OF-3
No. and Data 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)
Q
Cost
Per
Dollars
C;s.
Discount Terms
Costs
36,271
92,
PAYMENT:
Complete ^
Partial ^
Final ^
Use continuation sheet(s) if necessary
Shipped from to Weight Government B/L No.
Total
2 71
9
(Payee must NOT use this space)
I certify that the above bill is correct and just and that payment has not been received.
ATOTH R Differences ---------------------------------
-----------------------------------------------
---------------
---------------
-----
-----
a/ -----------------------------------------
---------------
-----
Date __!
Amount verified; correc~$or _
---------
6 .271
2
ST
Conti
Pursue
f App
By _.
SIGN
1 %,ORIGINAL
ONLY Title --------------------------- ------STATOTHR
-----------------------------------------
Title ---------------------------------------------------------- Date --------------------------------
STATOTH R THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
STATOTHR
I CChasech, k $ No. ________________________ dated ___---_-_______-_____________, 19_____, for $_____________-------_--_-_-___________ on Treasurer of the United States in
Paid by 1 favor of payee named above.
. on . 19 Payee ----- - ------ -- ---- --- --
(s4n cn?in',! only)
_
y i
D to Req. No.
unt is correct and proper for payment.
? When a voucher is signped~~or rec~e~Ipt~ed i t name ac~orn any or ~Q~y~s~iq~ tpc, c of f~ Q 1y~y::rspp1i~J ,f p p {~
writing the company orc~1i~Rk?11~~el e eei @l~lJlPv1WF .FiyFF~IR 6
4-0V3e0RVV0-400t11D090-7-----------
"John Doe Company, per m)th, rotary , or ' reIasurer e. case may bo.
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
over his official title.
 Approved For Release 2000/04/12 : CIA-RDP64-00360R000400110090-7
STATOTHR
Approved For Release 2000/04/12 : CIA-RDP64-00360R000400110090-7
 l tandard Form No. 1035a-Revised
Form Ares
Comptroller c~.vedFo'rT Ldi ~V~/fir EI [#~C - OR000400110090- *rt~~
September 18, 1960',M(~Rl~ ~vara
(Gen. Reg. No. 61, Supp. No. 11) Services Other Than Personal
CONTINUATION SHEET
U. S -------------------------------------------------------------------------------------------------- Sheet No. ----2------ of Bureau Voucher No. -34 3----
(Department, bureau, or establishment)
D
t
E
ARTICLES OR SERVICES
'ITN-
UNIT P
RICE
AMOUNT
No. and Date
of Order
a
eo
very
Deli
or Service
Federal supply schedules
(Enter description, Item number of contract or
and other information deemed necessary)
I i'Y
Cost
Per
Dollars Cte.
ELECTRONIC INSTRUMENTATION DIVISION
SCHEDULE OF OTHER COSTS M.J.0. 7003
Itextt
( Isek
P. 0.#
1
28427
22813
4;800 00
875 40
12
2
28716
22813
,
3
28603
Petty Cub
9 35
4
28426
Petty cash
3 00
5
8
Cash
6
354
2
23694
7
8
e8605 28648
24269
270 48
0
28350
22234
740 00
275 34
1
11
28354
28375
23694
23605
19376
12
28376
23791
2100
13
28376
23794
3 50
14
28404
24279
155 52
15
28405
24231
21 00
(772 32
16
17
28170
28459
22948
24256
248 49
18
28488
23665
170 52
176 95
19
20
28504
28504
24241
24242
328 87
21
28504
24243
71 77
22
28504
24244
139 35
318 04
23
24
28504
28680
24240
24646
42 35
25
28684
22244
26
28688
24247
TOTAL
$20: 706,
25
Approv
d For Release 2000/04/12 CIA-RDP64-00
60R
0040
1100
0-7
4
)