PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000600010080-7
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 2
• Document Creation Date: November 17, 2016
• Document Release Date: July 29, 1999
• Sequence Number: 80
• Publication Date: November 13, 1957
• Content Type: FORM

Standard. Form No. 1034-Revised
form prescribed by T
Cotnptrol-or General, U. S. `l! LIC V i
September
No. 51, A6Qn~?^ yed Fo a I;I
(Gen. Reg. g. N No. bl _ R'~6
2n 1952)
A _...._. ed L~..l.....
ary
A *Tt~
affi -00360 R000600010080-7
l~ ~ Bu. Vou. No- ---------------------------------
U. S. -------------------------------------------------------------------------------------------------------------------------------
(Department, bureau, or establishment)
Voucher prepared at --------------------------------------------ive p ---------
--------------------------
--- -----------------
(Glace and date)
THE UNITED STATES, Dr., Payee's Account No. ----------------
To ....... The--i amo-Wooldridge Corporation
---------------- - -------------------------------------------------------------
(Payee)
--_________ 8820 Ballanca Avenue------------------Los--Angeles 45, California
- - - - - - - - - - - ------- ----------------
(Address) (City) (State)
No. and Date of
O
d
Date of Delivery
S
ARTICLES OR SERVICES
(Enter description item number of contract or Federal supply
h
d
l
h
i
f
QUANTITY
UNIT PRICE
AMOUNT
r
er
or
ervice
sc
e
u
e, ant ot
er
n
ormation deemed necessary)
Discount Terms INVOICE NUMBERS
Cost
Per
Dollars
Cts.
-
1056
4,95+
37
37
1957
41258
03
1058
'
32.,471
72
1059
6,071
94
PAYMENT:
Complete ^
Partial ^
Final
Use continuation sheet(s) if necessary
Shipped from to Weight Government B/L No.
Total
L756
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)
Date -------------------- *Payee --------------------------------------------------------------------------
------
----------------------------------------
-
---------------
(Thi, aertifloete not renuired when a like cotiflonte le made by eayee on ntteehed bill o, bill.)
--
----
Amount verified; correct for -----------
--------------
-----
(Signature or initials) -----------------------------------------
Pursuant to authority vested in me, I certify that this account is correct and proper for
t Approved for $ -----------------------------------
SIGN
ORIGINAL
ONLY
Date ------ - -------------- - -
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown; other classification optional)
STATINTL
STATINTL
STATINTL
Check No. ------------------------ dated ------------------------------ 19_____, for $--------------------------------------- on Treasurer of the United States in
Paid by I. favor of payee named above.
Cash, $----------------------- on ------------------------------------- 19 Payee -
-----------------------------
(Sirn orleinal only)
When a voucher is signed or receipted in the name of a ~co}mpany or cor or t o th tLIQ so
writing thecom any orco~~pp ~y~a~g1~ ~P6-fl036``OR?Oflbf}?04{$0.r~_________
"Jahn Doo Co pany, ~cirJ6~ta4y*1!br~~bN"dFo
} 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 $ ---------------- ___1', and Title _______________________________________________________
over his official title. rs-22900-s
 r--liy -,- vy -'J LIC V ,{J
Comptrollor Gerteral, U. S.y
September
-.4,~~nr ed For ~6l
(Qen. Reg. No. 61, u Q
oo D. O. Vou. No. -------------------------------
4360R000600010080-7
U. U.S. ---------- --------------------------------------------------------------------------------------------------------------------
(Department, bureau, or establishment)
Voucher prepared at -------------------------------------------------------=------------------------------------------------
(Clive place and date)
THE UNITED STATES, Dr., Payee's Account No_ ----------------
To -------The- Rmw-Vb*)Arift*- -`'mOt'atio1s
------------ --------------------------------------------
(Payee)
_ irri:#wls - Av a Los - e1 _1 C&Uftz'n.*
---- - ----- -------- ----------
(Address) (City) (State)
Psge I Of 1
No. and Date of
Order
Date of Delivery
or S
i
ARTICLES OR SERVICES
(Enter description item number of contract or Federal supply
schedule
th
i
f
i
QUANTITY
UNIT PRICE
AMOUNT
erv
ce
, and o
er
n
ormat
on deemed necessary)
Discount Terms 3:1[11F= MINIM.
Cost
Per
Dollars
Cts.
37
k,
24 Wtl
03
79
1059
poll
94
PAYMENT:
Complete ^
Partial ^
Final ^
Use continuation sheet(s) if necessary
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 N3T use this s
7
Differences ---------------------=
-------
-
(Sign o riginal only)
-----------------------------------------------
---
---------------
--
--
-----
Date -------------------- MPayee -----------------------------------------------------------
-----------------------------------------------
(Thf aertifl-t..ot r.q.lred h... like utlfl..t. I. -do by my-
Amount verified; correct for
___________
-----
Per -------------------------------------------- Title ----------------------------------------
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
t ----------------------------------------------------
- -----------------------
(Authorized Certifying Officer)
Title -----------
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown; other classification optional)
Check No- ________________________ dated ------------------------------ 19_____, for $--------------------------------------- on Treasurer of the United States in
Paid Cash, $ - , on 19 Payee I favor of payee named above.
ayee - ------------------------------------------
cslc. oriel..) 00(y)
rr .,o.. o r..u., - ' b -1-1- .u - ... - - u -.-'any or corporation n or t so
"John writing Doe the Comptucompanyiyorcor/~bp 1~Y~p~e a e ~ 10
bFf4=00-36-GR000 ` ODI-G607-__-__-__
per/Ji9~~aly'vdr `~iltctt7`, t~tl~~ \J\J~V"7_
t If the ability to certify an authority to approve are combined In one person, one signature only is noo-
essary; otherwise the approving officer will sign on the line below "Approved for $------------------- ", and Title _______________________________________________________
over his official title. 16-22000-5