PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000400120053-7
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 3
• Document Creation Date: November 17, 2016
• Document Release Date: February 14, 2000
• Sequence Number: 53
• Publication Date: October 22, 1956
• Content Type: FORM

D. O
Standard Form No. 1034-Rovlsed
Norm prescribrll by roved For I$ sl~ P
Comptroller Gen
36OR
So
Mo. 7, 1 SERVICES OTHE I-IA flf -
A
(Gen. Reg. No. 51, Supp. 1962j1) Bu.
(Amended February 20,
----- -------COST REIMBURSABLE
us.
-
(Department, bureau, or establishment)
Voucher prepared at ------------- ---------------------------------------
---------------------------------------------------
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No_ ________________
---------------------------------------------------------
(Payee)
-------------------------------------------------------
(Address) (City) (State)
ARTICLES OR SERVICES
UNIT PRICE
AMOUNT
mber of contract or Federal supply
i
i
i
No. and Date of
No
Date of Delivery
tem nu
pt
on
(Enter descr
and other information deemed necessary)
schedule
QUANTITY
ll
rs
D
Cts
Order
or Service
,
Cost
Per
o
a
.
Discount Terms
costs
6,152
6
PAYMENT:
Complete ^
Partial ^
Final ^ Use continuation sheet(s) if necessary
Shipped from to Weight Government B/L No. Total
152
(Payee must NOT use this space)
I certify that the above bill is correct and just and that payment has not been received.
Differences --------------------------------
---------------
-----
(Sign original only)
STATINTL -----------------------------------------------
-------------
-----
10-10-56*
--
Payee Payee
Date -----
h -
(This ooet( .to not required w Amount verified; correct fora
Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
------------- ---
-------------------------------------------
Title ------- -------
THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown; other classification optional)
STATINTL
t --------
. Vou. No- -------------------------------
0004001200fi3-7
(Signature or initials) -------
Date
SAPC 647-5
COPY 09 "Z~
SIGN
ORIGINAL
Title -------------------------------------------------------------------------
ONLY
CONTRACTING OFFICER
Date
-------------------------------------------------------
STATINTL
110/Sod
LE :I I W'k 'T !'39 9961
Check No. ------------------------ dated ------------------------------ 19_____, for $____________-------------------------- on Treasurer of the United States in
Paid by { favor of payee named above.
---------------------------------
Cash, $ . on I< ------------------------------------- 19 ------ Payee ----------------------------- (S----. -on i-----or( -only)
writing the voucher is ~e~~~t~1 i~t e o a corn any r arse fEt c p r { r
? When a
company~Adri[g sl6bU tgR ~I~~srtil 4-OO36UFR00040~12V053-~
"John Doe company, per an Smith, Secretary", or ` reasurer", as he case ma o.
tIf the ability to certify and authority to approve are combined in one person, ono signature only is nec- Title _______________________________________________________
essary; otherwise the approving officer will sign on the lino below "Approved for $------ ------------- ", and
over his official title.
nrrnu,~?~ ?-.--
 Standard Form. No. 1035a-Revised j y~ ~]
Form pre ri,e~mp troller roved For F1 bb'Y&'b51b '~re~'/k~'
(SE1[ September 9W
(Con. Reg. No. 51, 8upp. No. 11) Services Other Than
CONTINUATION SHEET
COST REIA'1BURSABI Sheet No. ___-- ---- of Bureau Voucher No. ____+49
U S -----_-----------:-------------- --
lMs 0R0004O ft NDUM
ersona
No. and Date
of Order
Date of
Delivery
or Service
ARTICLES OR SERVICES
(Enter description, item number of contract or Federal supply schedule,
and other information deemed necessary)
STATINTL
STATINTL
STATINTL
Contract A101 - Costs applicable to
all systems
Direct Costs Properly Chargeable to
Contract AlOI for the period 9/21./56
thru 9/30/56
Labor Week Ending September 30,, 1956
Overhead computed for the Communications
Division at interim rate of
Other Costs
See sheet No. 2
Add - Adjustment for credit given in
error on Voucher #427
Total La70or, Overhead and Other Costs
G & A e} ense computed at interim rate
of
--- Ye PRIN 600360R000400120053-7
 8tan?ara Form No. 1035a-Revised
Form prescribed by
Comperpo er General II B or ReTe UrVlce8 ~} tI f P M_0004001 ~221I~ 9~553g-~77NDUIl~I
(Gen. Reg. upp, o. 1 e t er TA
an Personal 1~~ENIi'IRA
CONTINUATION SHEET
COST -REMI-IRSABLE-------------------------------------------------- Sheet No. -_---------- of Bureau Voucher No. _=_____
(Department, bureau, or establishment)
No. and Date
of Order
Date of
Delivery
ARTICLES OR SERVICES
(Enter description
item number
f
t
t
F
l
d
l
UAN-
UNIT PRICE
AMOUNT
or Service
,
o
con
rac
or
e
era
supp
y schedule,
h
ITY
and ot
er information deemed necessary)
Cost
Per
Dollars
Cts.
Check No. Payee No.
P. 0.
No.
Amount
394 GLIDE EAS
52934
302
08
466 GLIDE EAS
529314
1, 455
88
479 NTL WIRE
52903
'j-
33
15
488 QUALITY ELEC
2903
52903
3
92
474 PETTY CASH
5
50
436 TECH/GR.APHH
52957
44
77
TOTAL
$=.1 84
0
Approved For Release 20?AH 4&7wCIA-fit 64-0036080004001