PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000600010023-0
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 3
• Document Creation Date: November 17, 2016
• Document Release Date: July 29, 1999
• Sequence Number: 23
• Publication Date: December 30, 1957
• Content Type: FORM

Standard Form No. 1034--Revised D. O. Vou. No. _------------------------------
corppescribe by oved For ~ s~~ /RAeA 60R00060 023-0
Controller Qen l P
September 7, SERVICES OTHER THAN PE ON Bu. Vote. No. as
(Glen. Reg. No. 51, Sunp. No. 11)
(Amended Februg.ry 20, 1952)
U. S- -------- OST-REIMBURSABLE-------- ---------------------------------- -----------------------------------------
(iJepart.ment, bureau, or establishment)
Voucher prepared at -------------------------------------------------------------------------------------------------------
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No_ ----------------
Y10 -----------------------------------------------------------------------------------------------------------------------------------
(Payee)
----------------------------------------------------------------------------------------------------------------------------------------
(Address) (City) (State)
ARTICLES OR SERVICES
UNIT
PRICE
AMOUNT
d D
t
f
N
te of Delivery
D
(Enter description, item number of contract or Federal supply
TY
AN
o. an
a
e o
O
d
a
r Service
schedule, and other information deemed necessary)
QU
TI
r
er
o
Cost
Per
Dollars
Cts.
Discount Terms
Cost
796
.47
PAYMENT:
Complete ^
Partial ^
Final ^
Use continuation sheet(s) if necessary
Shipped from to Weight Government B/L No.
Total
796
--
.
(Payee must NOT use this space)
I certify that the above bill is correct and just and that payment has not been received.
---------------------------------
Differences
------
---------
-----
STATI NTL (Sign original only)
W_ ----------------------------------------------
Date -- 30157 * Payee ----------------------------------------------------------------------- ----------
.0 not ro?vired nben o like ,,ctlfitata is mndo by pays. on ntt..L.d bill or bil;.) e.
Amount verll]d: correct for _.-------_-
--------------+
--~/ ---------
-L
-----
--
Per
('entract No.~Ot<
-------- Title ----------------------------------------------I (Signature or initials) -_ -
Date
Req. No_ Date invoice Recd. -
Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
f Approved for $ -----------------------------------
By ------------------------------------- -----------------------
Title ----------------------------------------------------------
SIGN
ORIGINAL
ONLY
----------------------------------------
(Authorized Certifying Officer)
Check No- ------------------------ dated ------------------------------ 19------ for $-------------------------------------- on Treasurer of the United States in favor of
Paid by payee named above.
I Cash, $------------------------- on ------------------------------------- 19-----. Payee -------------------------------------------------------------------------
(sign original only)
' When a voucher is sine r recei t~~d ' the na f tom an o p~QQrpt' me o TAW
writing the companyord9[ c(,@~cQtl lQj o AC
"John Doc Company, per o n Smi h, Secretary or reasurer' , as he case may e.
t If the ability to certify and authority to approve are combined in one person, one signature only is nec-
essary; otherwise the approving officer will sign on the line below "Approved for $------------------- , and
over his official title.
N*003-60R$0U60-001-0023 =0______------
Title -----------
 Standard Form. No. 1035a-Rovised
escribed b
For;np oved For' fff
Comptroller ls 4 ~G
Beptemfier Go~-e
q 60R000~QM4Du dg
(Gen. Rog. No. 51, upp. No. 11) ervices er' an er'solla
CONTINUATION SHEET
U. S. ----- CQS.T-RE.IMRURSABLE----------------------------------------------------------- Shed No. ----1----- of Bureau Voucher No. __ 2QQ5-
(Department, bureau, or establishment)
Date of
ARTICLES OR SERVICES
I
A
-
UNIT PRICE
AMOUNT
No. and Date
of Order
Deliver
y
(Enter description, item number of contract or Federal supply schedule,
V
N
fill I?I?y
or Service
and other information deemed necessary)
Cost
Per
Dollars Cts.
Contract -/D System III
Direct Costs Properly Chargeable to
Contract Q( for the period
12/16/57 thru 12/22/57
Research &
Development
Pri
oducti
On
To al
STATINTL
Labor for
Week Endi
ng December 22, 1957
Other Cos
s - per
chedule attached
Potal Labc
r and Oth
er Costs
G & A exp
nse comp
ted at interim
rate of
total Cos
s
STATINTL
$__L96.47
Approved ied For Release OJO411r1l4 ;C F IA R R64-0036OR000600010023-0
 AI
~prov For, Rele
se 20
D0/04/
A-RD
64-0
360R00060
D0100
3-0
Ap~roveti For elea a 20 0/04/11 : Cl -RD 64-00 60RO 0600 1002 -0
THE STANDARD REGISTER CO. - PACIFIC DIVISION OAKLAND LOS ANGELES. U.S.A. STANLOCK PATENT PENDING ,
i lw W&F w qw w w