PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000600010068-1
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 6
• Document Creation Date: November 17, 2016
• Document Release Date: July 29, 1999
• Sequence Number: 68
• Publication Date: November 15, 1957
• Content Type: FORM

Standard Form No, 1034-Revieed
farm proscribed by ''UBLIC
CZiptroller General, U. S. XIM
leeptembJfP rq,1
V1 d For Ry
(
Gen. e
Reg. No.
(Amended Februarv 2(i. 19fi21
Payee's Account No. _______________-
U U.S. ------ GOST-MMEMSAM
------------------------------------------
(Department, bureau, or establishment)
Voucher prepared at
THE UNITED STATES, Dr.,
To =
-----------------------------------
--------------------------------------------------
(Payee) -----------
-----------------------------------------------------------------------
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)
Discount Terms
PAYMENT:
Complete ^
Partial ^
Final ^
? 1 r D. O. Vou. No. -----------
0068-1
- --------------
TPERSONAL L R-- .r___ -I n7n
Shipped from to --,
Weight Government B/L No. Total
I certify that the above bill is correct and just and that payment has not been received. (Payee must NOT use this space)
STATINTL
Per
e nut reaoired when a like 'ertifoete f. made bs ssree an eiteohed bill or bill.)
_______ Title
Differences
-------------------
Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
f Approved for $ ---------------------
By ------------------------------------------------------------
SIGN
ORIGINAL
ONLY
-----------------------------------------
-----------------------------------------------
----------------------------
Amount verified; correct for
(Signature or initials) --
Date
SAPC
COPY OF n
28
t ----------------------- ----------- ----------------------- - - -
(Authorized Certifying Officer)
Title
Date -----------------
------------------------
HE 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)
Check No. ------------------------ dated 19 for $
Paid by jl ____________________ Jon Treasurer of the United States in favoe r+;
Cash. $------------------------- on -------- payee named above.
------?-?-----------------. 19 ------- Payee ------------------ - -?
-----------------
(alas oriaimi ?ni
When a voucher is signed or receipted in h ame
t
,a
o
~ a
6writing toe r co~orsi Y ; -
7 u~c a r. oRo rFIts rtz4>
John Doe Company e t
a
'
y , or Treasurer
, as the case may be.
tIf the ability to cart fy 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 odicial title.
@P64-OIl36QRO..0600010068-1
Title ------------------------?--------------'
 Standard ForJd- rained eor Rejease 2100/04/11 CIDp64-0036QR000600010068-1
Foemr crbedby ! VV Y h edl
comptroller C+eneral, 9L7. S. a is ouches or" Pure ases,..n
September 7, 1960 MEMORANDUM
(Gen. Reg. No. b1, Supp. No. 11) Services Other Than Personal
CONTINUATION SHEET
U. S. ------ COST_ REINHJRSABLE-------------------------------------------------------- Sheet No. ---- =----- of Bureau Voucher No. --I 7Q-
(Department, bureau, or establishment)
No. and Date
Date of
li
D
ARTICLES OR SERVICES
Y-
UNIT PRICE
AMOUNT
of Order
e
very
(Enter description, item number of contract or Federal supply schedule,
I TT
TY
or Service
and other information deemed necessary)
Cost
Per
Dollars
Cts.
SAP
Z/
Contract A101 - Costs applicable
to
,
All Systems
CO~
`f f OF
Direct Costs Properly Chargeable to
Contract A101 for the period 11/4/57
thru 11/10/57
Research &
Development
Pr
ucti
n
To
al
STATINTL
abor for
Week Eh
rag November 10, 1957
-verheed c
omputed
or Communications
nvision
t interix4
rates as follows:
Rese
ch & Dev
lopm~t
Produc
tion
STATINTL
STATINTL
ther Cost
s - per
chedule attached
otal Lab
r, Overh
ad and Other Costs
& A exp
use c
ted at interim
ate of
1+0 659
28
STATINTL
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