PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000600010093-3
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 2
• Document Creation Date: November 17, 2016
• Document Release Date: July 29, 1999
• Sequence Number: 93
• Publication Date: April 18, 1958
• Content Type: FORM

Standard Form No. 1034-Revised
'T'orm prescribed by
Comptroller General, U. S. PUt' 7C VOUc,
'
Septomb4r~ed For Rely
" (Gen. Reg. Novo ,
- (Amended February 20, 1952)
3fiQR0006000Jp93-3
Bu. You. No. ---------------------------------
U. S. ---COST REIMBURSABLE
(Department, bureau, or establishment)
Voucher prepared at --------------------------------------------------------------------------------------------------------
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No. ---------
----------------------------------------------
--------------------------------------------------------
-----------------------------
(Payee)
----------------------------------------------------------------------------------------------------------------------------------------
(Address) (city) (State)
PAID BY
e
DPS-00AAl
No. and Date of
Ord
Data of Delivery
S
i
ARTICLES OR SERVICES
(Enter description item number of contract or Federal supply
h
d
l
d
h
i
f
QUANTITY
UNIT PRICE
AMOUNT
er
or
erv
ce
sc
e
u
e, an
ot
er
n
ormation deemed necessary)
Discount Terms
Cost
Per
Dollars
Cts.
Cost
258
38
PAYMENT:
Complete ^
Partial ^
Final ^
_ Use continuation sheet(s) if necessary
Shipped from to Weight Government
B/L No. Total
2 8-
5__J
-
38
1 certify that the above bill is correct and just and that payment has not been received.
(Payee must NOT use this space)
Differences
STATI NTL (Si.. original only)
--------------------------
-----------------------------------------------
---------------
----
Date 18 W
---
-
not required when alike sertiseste is sense by cnyee on aitiohea bill or biil.i
Amount verified; correct for --------
";?IS_x
-3J
Contract No. /9 xe /
Req. No. Date Invoice Recd.
SIGN
ORIGINAL
ONLY
------------------------------------------------------
(Authorized Certifying Officer)
Title -- ? - -
Title --------------------------------------------------------- Date
THE 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 $______ -------------------------------------- on Treasurer of the United States in favor of
Paid by [payee named above.
Cash, $ on' -----------------------------______.19 -----. Payee ------------------------------------------------------------------------
(sign original only)
------ Title ---------------------------------------------- (Signature or initials
o When a voucher is signed or receipted in the name of a company or corporation, the n m
ae of the person
the company Per________________________________________________________________
writin thaswell as the capacity pp(
g or corporate name, in which he signs, must a
ar. For exampl
John Doe Company, e s
}If the ability to certlf 0i, lr~'.ft" 9"Ma~rre P~AnR P64tg0360R000600010093-3
essary; otherwise the approfficer will sign on the line below "Approved for $________
",and
over his official title. ia-zseoo-s
 . standard: Form No. 1035a-Revised
arm prescribed by Publ' Voucher for Purchases and
Comptroller General, U. B.
(Gen. Reg. No 8e; rAved For g ig~ g#/ ~gllo-M g~1r00360ROO DUM
U. S. _-COST REIMBURSABLE .__ Sheet No. ____, of Bureau Voucher No. 2082
- - - REIMBURSABLE --- ------------
(Department, bureau, or establishment)
No
and Date
Date of
ARTICLES OR SERVICES
AN-
UNIT PRICE
AMOUNT
.
of Order
Delivery
(Enter description, Item number of contract or Federal supply schedule,
irry
ITy
or Service
and other information deemed necessary)
Cost
Per
Dollars
Cts.
Contract ,4L-/dl Costs applicable
to All Systems
Direct Costs Properly Chargeable to
Contract ,4-,'v for the period 4/7
thru 4/177-
STATINTL
Research &
Development
Pr
ucti
n
To
tal
Labor
or the W
ek Ending April 13, 1958
JV
038060
STATINTL
Overhe
for Co
ieations Division
compute
d at inte
rim rates as follows:
Res
earch & D
evelopment -
Other c
osts -
038019 19.25
038040 46.75
Total
or, Ove
rhead and Other Costs
G & A
xpense co
mputed at interim
rate o
Total C
osts
STATINTL
$ 258
-38
Approved For Release 2000/04/11 : CIA-RDP64-0036OR000600010093-3