PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000600010033-9
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 9
• Document Creation Date: November 17, 2016
• Document Release Date: July 29, 1999
• Sequence Number: 33
• Publication Date: December 20, 1957
• Content Type: FORM

andn.T?d Form No. 1034-Itoviscd D. U. Von. No. --------------------------
Com?Form prescrlb~d by ~oved For RLs
Pr toher Qen
(Geri. Reg. No. 51, Supp. No. 11) 10/- L4~~V? ?pct-Qb360R000600010I~33-9
--------------------
mber i 1 SERVICES OTHER THAN PERSONAL( Et.. Von. No. ------ _ _
(Amended February 20, 1952)
U. S. ----COST _ REIMBURSABLE----------------------------------------------------------------------------------------
"Voucher prepared at ---------------------------------------------------------------------------------------------------------
THE UNITED STATES, Dr.,
(Give place and date)
Payee's Account No- ----------------
To -----------------------------------------------------------------------------------------------------------------------------------
(Payee)
ARTICLES OR SERVICES
UNIT PRICE
AMOUNT
No
and Date of
Date of Delivery
(Enter description item number of contract or Federal supply
ANTITY
.
O
S
i
and other information deemed necessary)
schedule
QU
rder
or
erv
ce
,
Cost
Per
Dollars
Cts.
Discount Terms
Cost
17,082
87
PAYMENT:
Complete ^
Partial ^
Final ^
Use continuation sheet(s) if necessary
Shipped from to Weight Government P/l. No.
Total
17,082,
67
(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)
----------------
-----
------------------------------------------------
Date -Pay ce ----------- ----- ---------------------------------- --------------------- ------------------ -
---- ----------
----------
6_
-----
-
to rot rea i ou wl~c.r a like cert:Gcate ie made by nayea on atteahed bill or b;lle) I
Amount verified; correct for r _ - - __
v
,
Per - Title ----------------------------------------------I (Signature or initials) ._--
Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
SIGN
ORIGINAL
ONLY
r ------------------ - ---------------------------------------------------
(Authorized Certify irg Officer)
Title -------------------------------------------------------- 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 $-------------------------------------- fon Treasurer of the United States in favor of
Paid by (payee named above.
{ Cash, $------------------------? on ------------------------------------, 19------ Payee -------------------------------------------------------------------------
(ei'n original only)
e er
? When a voucher is s ,Qr,~e ei tgd n a nan f e.cam an o p~pQ~j~t' n m~ o ? 1
writing the company or # f ? fie 7E$'eas o1~1 c r.:
per Jdhn Smith, Secretary , or reasurer' , as he case may e.
"John Doe Company
,
tIf 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 $---------------------- and
over his official title.
P64-=003SOROOO6O 01-0033=9------------
Title ---------------------- -----------------------------
1c alslle-e
 A r%
Standard F~.r p1GQyR4ljepr Release 2000/04/11 : CIA-RDP64-0036OR000600010033-9
Form prescribed byy
flompptroller Qetter~l,_U. 8, iblic Voucher for Purchases !d
Fleptember 7 1850
(Glen. Reg. No. 51, w upp, No. 11) 'Services Other Than Personal MEMORANDUM
CONTINUATION SHEET
U. S. _____COST REIMBtJRSABLE________________________________________________________ Sheet No. ---l.---- of Bureau Voucher No. --_109$
No. and Date
Date of
ARTICLES OR SERVICES
UAN-
AN-
UNIT PRICE
AMOUNT
of Order
Delivery
r
i
S
(Enter description item number of contract or Federal supply scheda?Iei
V
or
e
ce
v
and other Information deemed necessary)
Cost
Per
Dollars
Ct8.
Contract , l O / System II
Direct Costs Properly Chargeable to
Contract 4;(01 for the period
11/25 thru 12/15/57
STATINTL Research &
Development
Pi
oducti
n
%
ta:
Labor for
the peri
od 11/25/57 thxu 12/15/57
JV 1
7060
iv 13
,7o65
JV 13
,7720
Other Co
ts - per
schedule attached 2,229.41t'
shee
t # 2 1,311.38
Total La
or and 0
er Costs
G & A e
se com
ted at interim
rate of
Total Cos
s
17,082.
7
STATINTL
Approved For Release 2000/04/11 : CIA-RDP64-0036OR000600010033-9
 aitandard :E'orin No. 1O3 a-Il evised
Form prescriier b, S. v
fic Vol
Com
~
ptroller rieral. U21E
Septemberroved For R a
se 20
ir
'
ier Ilan
OR0006WOR A DU f
CONTINUATION SHEET
U. S. ----- OST_ REIMBU 5AXZ__________________________________________________________ Sheet No. __2_______ of Bureau Voucher No. __ ZQ98_
(Department, bureau, or establishment)
No. and Data
of Order
Date of
Delivery
ARTICLES OR SERVICES
(Enter description
item nu
b
f
F
d
l
l
UAN-
UNIT PRICE
AMOUNT
or Service
,
er o
m
contract or
e
era
supp
y schedule
ITY
and other information deemed necessary)
Cost
Per
Dollars
Cts.
TICKET
INVOICE
CR MEMO
CHECK ~
PAYEE OR VENDOR NO.
1689
12117
64 457.68
451
.68
JV 1170
0
23.76
JV 11704
0
829.94
5$ 3.70
853
-70
v
WTAL
$131
.38
.. ..
..~ is I
1
_.
I
ra
Approved For ReIease- 20OW04MI-i,CIA F DP64-00360 R000600010033-9
 V" Iw
Y
Approved For Release 2000/04/1,1 :
CIiA-ROPE4-vOO3 -0RQO*06'OM0IDD33=9r
I I i I
AIprov d For! RelO
I . ~
mw mw mv Iw
se 201
0/04/
1 : Cl
A-RD
64-O036OR
-W I w to
 w %W r q
Approvod ForIRelea~e 2000/04/
AOprovep For lRelea
e 2000/04/
- w w
1 : CIA-RDR64-00
1 : CIA-RDP64-00
*01
 A0
pov
ww
d For
aIw II .-
Relealse 20
0/04/
64-066O R600606010'61-9'
4
e+
Aplproved For Releate 2000/04/111 : CIA-RDPI64-00360R000600010033-9
FORM Ho. 1128 THE STANDARD REGISTER CO. ? PACIFIC DIVISION OAKLAND LOS ANGELES, U.S.A. $TANLOCK PATENT PENDING
1 : CIA-RD
.w .r w ww w *40 w w qw w w w w
 Approv
d For ReleageA2090%04111
e
I I
44
Aoprov7 ,,~d For (Relea
&W 1 *01 w MW
e 200
0/04/
1 : Cl
-RDP64-001360R00060
 : Vin. 1M 3J.N!`?nl N,4
Relea a 200/04)11 : C1~4=1 0 =0 r ~l~' `0601DI00
Release 2000/04/11 : Cl
-RDP64-00
 Ap ov~
d For
Relea
~e 20
0/04/1
I Approved For Releate 2000/04/1
1 : CIA-RD
1 : Cl
POP" NO. 1128 THE STANDARD REGISTER CO. - PACIFIC DIVISION OAKLAND LOS ANGELES. U.5.?
64-001360R000600
ww
4-4
w
N4
cc
00
~Y
-RDR64-00360R0100600
?TANLOWL PATENT PENDING
t t.