PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

Document Type: 
Collection: 
Document Number (FOIA) /ESDN (CREST): 
CIA-RDP64-00360R000400120014-0
Release Decision: 
RIPPUB
Original Classification: 
K
Document Page Count: 
2
Document Creation Date: 
November 17, 2016
Document Release Date: 
February 14, 2000
Sequence Number: 
14
Case Number: 
Publication Date: 
November 9, 1956
Content Type: 
FORM
File: 
AttachmentSize
PDF icon CIA-RDP64-00360R000400120014-0.pdf98.45 KB
Body: 
Form prescribed by pr~q j(+O'fflV5 I~!11~1(a` 1~'(1R Comptroller ler Ge penr __fOVed For. j~ ` (pen. Reg. Nom. 51 Supp. No. 11) SERVICES OTHER TH N (Amended February 20, 1962) 400120014-0 U. S- --------------------------------------------- oal-m : -Ro ---------------------------------------- (Department, bureau, or establishment) Voucher prepared at -------------------------------------------------------------------------------------------------------- (Give place and date) THE UNITED STATES, Dr., Payee's Account No. ---------------- To ----------------------------------------------------------------------------------------------------------------------------------- (Payee) ---------------------------------------------------------------------------------------------------------------------------------------- (Address) (City) (State) No. and Date of Order Date of Delivery or Service ARTICLES OR SERVICES (Enter description item number of contract or Federal supply schedule, anti other Information deemed necessary) Discount Terms PAYMENT: Complete ^ Partial ^ Final ^ Shipped from to Weight Government B/L No. I Total I (Payee must NOT use this space) Date *Payee----------- ----------------------------------------------------------- to not squired when like eertideate i. made by payee on attached bill .,bill.) Per Contract No.A101 Pursuant to authority vested in me, I certify that this account is correct and proper for payment. t -------- SIGN ORIGINAL Title ---- ONLY 31 38 --------------- ---------------------------------------- --------------- - - Amount verified; correct for ----------- 3 (Signature or initials)----------------------------------------- Title -------------------------------------+r--u-v- -----LUw Date ------------------------------------------------------------------------- THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM Check No- ------------------------ dated -----------------------------, 19---__ for $ ------------------------------- on Treasurer of the United States in favor of Paid by payee named above. Cash, $------------------------- on ------------------------------------+ 19-----. Payee -----------------------------(ai3n----------origin,)----only) ----------------------------- e When a voucher is s*g@$ s5v i'es t j~Yin ~~iu'st pasi~ ' l lisnr R-0004oa~2oa44-0 writing the company or cbt'pb ert YI ---------------------------------- a "John Doe Company, per John Smith, Secretary", or "Treasurer'', as the 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 18-229Wi over Ti h s official title. Co m prescribed by_&Ved Ford Corn troller (lone1 ~j September 7. (Gen. Ileg. No. Cl, app. No. 11) ervices t er all U. S -------------------------------- Sheet No. _- 3'------- of Bureau Voucher No. `k? -- (Department, bureau, or establishment) Date of ARTICLES OR SERVICES QUAN- UNIT P RICE AMOUNT No. and Date Delivery or Service (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary) TITY Cost Per Dollars Cts. Contract AlOl - System IV Direct Costs Properly Chargeable to Contract AlOl for the month of September, 1956 STATI TL Labor for the month of September, 1956 STATI TL Overhead computed for W ID Division at interim rate of Total Labor and Overhead G & A expense computed at interim rate STATI TL of Total Costs $ 31 38 00120014-MEMORANDUM Approve or Release 200 //D5/O3 sC 64-0O OR000400120014-0