PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000500020094-2
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 3
• Document Creation Date: December 9, 2016
• Document Release Date: September 15, 1998
• Sequence Number: 94
• Publication Date: December 27, 1956
• Content Type: FORM

cand.ard For= No. 10P4-Revised
Form proscribed by p
Comptroller G! fIgfbijed For I~el %w -
September
I* `t
(Gen. Reg. . N No- 51, Supp. No. 11)
SERVICES OT
(Amended February ary 20 20, 1962)
SIGN
ORIGINAL
ONLY
U. S. _----- COST RE AHLE
------------------------------------------
(Department, bureau, or establishment)
Voucher / repared 'at ----------------------------------------------------=---------------------------------------------------
((live place and date)
THE UNITED STATES, Dr., Payee's Account No. _______________-
To -----------------------------------------------------------------------------------------------------------------------------------
(Payee)
-------------------------------------------------------
--------------------------------------------------------------------------------
(Address) (City) (State)
No. and Data 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)
Discount Terms
PAYMENT:
Complete ^
Partial ^
Final ^
saps r 11~-v /
COPY 1of 2--
Shipped from to Weight Government B/L No. I Total
I (Payee must NOT use this space)
I certify that the above bill is correct and just and that payment has not been received.
* Paves ------
ot required when a like eertiaoate ie made by my.. oa etteobed bill or bills)
Per
Contract No.
---- Title --------------------------------------------
Date Req. No.
Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
~~{{ D. O. Vou. No..--------- -------------------
961V 8w
002B . Vo No- ------ 57-6-------------------
-----------------------------------------------
------------------------------------------------
Amount verified; correct for ------ - ---
2 /L
0WAO-00
W
Date
APPROVING OFFICER . i-~ I ; -1 100
_
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5 t 9
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Date --------------- --
--
--
-
-
---
Title ------------------------------------- -----------------
FOIAb3b 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 Iavw of
payee named above.
Paid by
Cash, $------------------------? on -------- 19-----? Payee ------------------- -----i81?n orianei uuiy) ---------------------------
------------
hen
vouc>aenrslzafl~,pL~e~aVT4v11Tt'?i~ac~t'3liAAv~~s >~e~8$1Lbt1 ft$-2 ?-
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"ohnoe 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 net- Title _______________________________________________________
essary; otherwise the approving officer will sign on the line below "Approved for $__________________", and 1e-zzsoo-+:
over his official title.
 Approved For Release 2001/08/01 : CIA-RDP64-0036OR000500020094-2
METHOD OF OR ABSENCE OF ADVERTISING
1. Advertising in newspapers Yes ^ No ^.
2. (a) Advertising by circular letters sent to -------------------- dealers.
(b) And by notices posted in public places Yes ^ No ^.
(If notices were not posted in addition to advertising by circular letters sent to dealers, explanation of such omission must b?
made below.)
8. Without advertising, under an exigency of the service which existed prior to the order and would not admit of the delay incident to
advertising.
4. Without advertising in accordance with ------------ -------------------------------------------------------------------------------- -------------------
--------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------....
(Here state in detail the nature of the exigency or circumstances under which the securing of competition was impracticable under 3 and 4)
NOTE.-The above form "Method of or Absence of Advertising" is to be used when purchases are made or services secured undea
proper authority without written agreement in any form. In case of a written agreement (formal contract, proposal, and acceptance, of
less formal agreement) Standard Form No. 1036--Revised should be used for abstracting the method of or absence of advertising and
award of contract. (See General Regulations No. 51, as amended.)
Approved Far Release 2001/08/01 : C14-RQP64-00360R000500020094-2
 Approved For ReMeJSJW S
ORIGINAL DOCUMENT MISSING PAGE(S):
fl2 1 3 0500020094-2
Approved For Release 2001/08/01 : CIA-RDP64-00360R000500020094-2