PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

Document Type: 
Collection: 
Document Number (FOIA) /ESDN (CREST): 
CIA-RDP64-00360R000400120074-4
Release Decision: 
RIPPUB
Original Classification: 
K
Document Page Count: 
3
Document Creation Date: 
November 17, 2016
Document Release Date: 
February 14, 2000
Sequence Number: 
74
Case Number: 
Publication Date: 
October 11, 1956
Content Type: 
FORM
File: 
AttachmentSize
PDF icon CIA-RDP64-00360R000400120074-4.pdf136.01 KB
Body: 
(Gen. Rog. No. 51, Supp. No. 11) SEKVICLS UI'HEK THAN YEKSUNAL (Amended February 20, 1952) U. S. - COST- iit`1. UR B (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 Date of Delivery ARTICLES OR SERVICES (Enter description item number of contract or Federal supply d QUANTITY UNIT PRICE AMOUNT Order or Service schedule, an other Information deemed necessary) Discount Terms Cost Per Dollars Cts. Costs 1,663 13 PAYMENT: Complete ^ Partial ^ Final ^ Use continuation sheet(s) if necessary Shipped from to Weight Government B/L No. Total 1 663 , I certify that the above bill is correct and just and that payment has not been received. (Payee must NOT use this space) Differences --------------------------------- --------------- ----- (Sign original only) STATINTL ----------------------------------------------- --------------- ----- Date ---- ----------------------------------------------- ----- ---------- ----- Ired whe bill,) Amount verified; correct for _________-_ - t 6 5L 3 Title Contract No. A101 Date Req. No. Pursuant to authority vested in me, I certify that this account is correct and proper for payment. SIGN ORIGINAL ONLY . (Signature or initials) -- r 27'' -_---------------------------- Title ---------------------------------------------------------- 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 Symbol must be shown; other classification optional) I CChecaeh, k $ No- -______________________ on _ dated ___-_------------------------, 19 19 _-___, for $_-_________------------------_________ on Treasurer of the United States in Paid by , favor of payee named above. Payee ------------------------------ (aign o,igin..l only) ? When a voucher is Al. ed or receipt the qm of a comp~q~ rpgiy~on, q a T writing the company ort9lfOW s OUa iQB ~$t@irritlYW1 193s0s p aKlHb~' 6Ere( gQROOfl flfl'}2flfl7 = " John Doe Company, S n mit , ecretary", or "Treasurer", as the case may be. If the ability to certd 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. stamclardForm No. Form r U i Lre ` U gd For Rel (T(~ITO~TDC3 ~TA RbI ~ 20074-4 MEMORANDUM September 7, 1950 (Gen. Reg. No. 51, Supp. No. 11) Services Other Than Personal CONTINUATION SHEET U. S C_C T REINtBURSABI ------------------------------- Sheet No. ---1------ of Bureau Voucher No. ---4.2d--- (Department, bureau, or establishment) No. and Date of Order STATINTL STATINTL Date of Delivery or Service ARTICLES OR SERVICES supply schedule, (Enter description, item number information of contract or Federal deemed necessary) on e Contract A1O1 Applicable to all Systems Direct Costs Properly Chargeable to Contract A101 for the period 9/3/56 thru 9/9/56 Tabor Week Ending September 9, 1956 Overhead computed for the Colmmunications Division at interim rate of Other Costs - per schedule attached Tgtal Labor, Overhead and Other Costs G d A expense computed at interim rate of QUAN- TITY 1 66 L43-/'1i Q U. S. GOVERNMENT PR N NG O IC Q0400120074-4 S; adard Form No. 1085a-Revised rescribed by 1,1 .}09/WC&Ar 2 4db P ( it074-4 ~? irf 1 ?`~ ~?l for Relea Coeepte b r 7 1"I Services Other Than Personal (0,.. Reg. No. 51, t3 N- No. 11) MEMORANDUM COST REINlBURSALM------------------------- Sheet No. ----- ----- of Bureau Voucher No. --- 2o. (Department, bureau, or establishment) No and Date Date of ARTICLES OR SERVICES QUAN- UNIT PRICE AMOUNT * of Order Delivery (Enter description, item number of contract or Federal supply schedule. TITY or Service and other information deemed necessary) Cost Per Dollars Cts. Cke Payee P.O. 4 Arno -t 85 PETTY CASH 3- 30 PETTY CASH 74 8 71 SELL RADIO 529131 70 72 CSICAGO STAND 529133 52 03 v or a ease w- - 5 R