PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000600010085-2
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 4
• Document Creation Date: November 17, 2016
• Document Release Date: July 29, 1999
• Sequence Number: 85
• Publication Date: October 31, 1957
• Content Type: FORM

~I~'orm prescribed b .,
?olhptr?"erg?~~rwed For.R~~e~~~/~~~ G~~"*Od360R000600010085-2
September
' (~(~>ne dad February 0 962)1) SERVICES OTHER THAN PERSONAL' Ilu. vo... No. ___~Q-~~_____________________
U. S. ------~D~~__F3~~i~~A~J.tE -----------------------------------------------------------------------------.--------
(Department, bureau, or establishment)
I/oucher ~re~ared at --------------------------------------------------------------------------------------------------------
(Qive piece and Gate)
THE UNITED STATES, Dr., Payee's Account No_ ________________
To
----------- ------------------------------------------------------------------------------------------------------------------------
(Payee)
(Address) (Oity) (State)
No. and Dako of
O
d
Date of Delivery
S
ARTICLES OR SERVICES
(Enter doscrlption item number of contract or Federal supply
h
d
l
d
h
i
f
QUANTITY
JNIT PRICE
AMOUNT
r
er
or
ervice
sc
e
u
e, an
ot
er
n
ormation deemed necessary)
Discount Terms
Coat
Por
Dollars
Cts.
COST
~+6, 071.
g~+
PAYMENT:
Complete ^
Partial ^
Final ^
Use continuation sheet(s) if necessary.
Shipped from to Weight Government B/L No.
Total
071.
I certify that the above bill is correct and just and that payment has not been received.
(Payee must NOT use this space)
STAT~ NTL
Si
Differences _______________________ ----------
---------------
-----
(
gn original only)
1,~~ lw
Date --------~ ----~
---------------------------?-------------
----------------------------------------------------------
ot reQUiredwhen alike eertidonte f. made br parse on .ttaohM bla oe bills)
-----------------------------------------------
Amount verified; correct for ____
_ _
- ------------
~ /~ p7/ .
'S` ,
-----
~~
j~
Pe _____ Title _________________.____________________________ (Signature or initials) _______../~
Contract No. A].~]? Date Req. No. Date Invoice Rec d.
Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
SIGN
ORIGINAL
ONLY
------------------------
(Authorized Oertifying Officer)
Title --------------------------------------------------------------------------
Title -------------------------?---?-------------------------- Date -------------------------------------------------------------------------
TIiE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERYICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
Patd b ~ Check No_ ________________________ dated ______________--_____________, 19_____,for $______________________________________ fen Treasurer of the United States in favor of
y `payee named above
Cash, $------------------------~ on ------------------------------------~ 19-----? Payee -------------=-----=----------------------------------------------------
- (seen orieinel onir)
? w nen a vaucner is st en or rocel tea 1 t nam a ompa~n or~,p o oP rsp~ /~!~y Dn ~ c f~ f~ f~ f~ p G
writblgthecompanyorc p e (~B ' ~p1b~~1~t~i~Y;P~aF'? .l'~PIQ 6~~VVJV?7TV?WVVO'~Z7VCli~~-----------
"Tohn Doo Qompany, p r t oar ', o a-su er , ss o case may c.
tIf the ability to certify and authority to approve are combined in ono person, one signature only is nec? Ti
l
t
e _______________________________________________________
essary; otherwise the approving ofiioer will sign on the line below "Approved for $_.______ ", and
over his official title. `-- ra-zzeoo-a
 Form rescri
~~~~~rh~~Releas~2~~0~/~~~~i~~1Q~5~ ~~~~2~ 0001008~~~~~~~~
eptem er 1 50 ~
y. (Gen. Reg. No. 61, Cupp. No. 11) ~erViees Other ~'han Pers?n.,-~
CONTINUATION SHEET
j~ Sh N 1 f B V h N 1x59
U. S. ----~Q~`~'__~'i.~ ----------------------------------------------------------- set `:?? ------------ o ureau ouc er o. ------------
(Department,. bureau, or establishment)
No. and Date
of Order
Date of
Deliver
Y
ARTICLES OR SERVICES
(Enter description, item number of contract or Federal supply schedule,
CTNIT PRICE AMOUNT
QUAN
TITY
or Service
and other information deemed necessary)
Cost Per Dollars Cts.
Contract AlOl -Costs applicable to
~ ~
All Systems
I
Direct Costs Properly Chargeable to
Contract A7..01 for the period 10/21/57
~
i -
thru 10/27/57
STATINTL
Research &
Development
Pr ducti n Tot 1
STATE NTL
Overhead
omputed
ar Communications
Division
tinter
rates as follows;
Resear
h & Deve
opment -- STATINTL
Produc
ion -
Other Cos
s -per
chedule attached 3,0+3,60 ,
Jv 1
7728 x+89. g2
Total Lab
r, Overh
ad and Other Costs
G & A e
nse com
ted at interim
rate o#
STATINTL
$ ~+6 07 ?9~
Total Cos
s
pprove or
a ease ~ . , o~R ?r F. OF~~
~~fb~0~~~83~~-
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