PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONA;L

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000600010120-2
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 2
• Document Creation Date: November 17, 2016
• Document Release Date: July 29, 1999
• Sequence Number: 120
• Publication Date: March 21, 1958
• Content Type: FORM

stand rd Form No. ld34-Revised
Form prescribed by-- loved Fore
Comptroller (3e
September ,
(Gen. Reg. No. 51, 61155. INC. 11)
(Amended February 20, 1952)
036~Rg00.00~.120-2_-____-_--_
9
U. S. _---COST--RE ftSABLE ------------------------------------------
------ ---------------------------------------------- --------------------------
-- -----------
------------------ (D--------epartment, bureau, or establishment)
Voucher prepared at ------------------------------------- ----------------------------
(Oive place and date)
THE UNITED STATES, Dr., Payee's Account No. ________________
---------------------------------------------------------
o
(Payee)
-------------------------------------------
- - --------------------------------------------
- -) City)_ _(State)
(Add dress ) (
ARTICLES OR SERVICES
No. and Date of Date of Delivery (Enter description item number of contract or Federal supply QUANTITY -
Order or Service schedule, and other information deemed necessary)
Discount Terms
PAYMENT:
Complete ^
Partial ^
Final ^
Use continuation sheet(s) if necessary I
Weight Government B/L No. Total
I (Payee must NOT use this space)
I certify that the above bill is correct and just and that payment has not been received.
STATINTL
450-
34
V5-0 - 3K
Date *Payee
----?----- .i.-d ..Seu s nk....eia.wte is m de br ones oa nttnoh,d bill or bills)
---- ----- --?
Contract No 4 (Ll 1l Date Req No Date lnvorce tree a.
Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
By -----------------------------------
--------------------- ---- ------ - ------------
SIGN
ORIGINAL
ONLY
----------------------- -----------------------------
t (Authorizzed ed Certifying OfDcer)
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)
-------------------- on Treasurer of the United States in favor of
Check No. dated 19 for $ {payee named above.
--- fsi:a o,;gloa odr>
Paid by Cash, $------------------------- on ------------------- y
? When a voucherA ~ri ~oe~cldlasltTt~$ aiiLbill 41T ~ t pC,tifi e e p 403FOR000 0010120-2
writing the compan o
er ruts Rmith- 9nerrtnav". or "Treasurer as a case ma b . _
. ... .. ... ......
p
tIf the ability do certify and authority to approve a.~ ~~ ..................... ~ .,--~--, -- 11
, and I
essary; otherwise the approving officer will sign on the line below "Approved for __-____________
over his official title.
Title -------------------------------------------------------
311 --22900-6
 Stan.4ard Form No. 1.03E5a-Revised
Fprm mb ribedb ed For-fit fx e,
Com troller
r ~4-
eptem OR0006Q q
(Gen. Reg. No. 51, upp. No. 11) ervices t er an ersoira
CONTINUATION SHEET
U. S . --- C-O ' --P I -BLL----------------------------------------------------------- Sheet No. --- ----- of Bureau Voucher No. --9954 (Department, bureau, or establishment)
Date of
ARTICLES OR SERVICES
Q
UNIT PRICE
AMOUNT
No. and Date
Delivery
Item number of contract or Federal supply schedule,
(Enter description
TTY
of Order
or Service
,
and other information deemed necessary)
Cost
Per
Dollars
Cts.
Contract ,j - ,; System IV
Direct Costs Properly Chargeable to
Contract for the Week Ending
3/9/58
STATIN
L
Labor for Week Ending 3/9/58
STATINT
Overhead for Control Systems Division
computed at interim rate of -
Total Labor and Overhead.
G & A ense cone. uteri at interim
rate of
STATINTL
Total Costs
$ 450
.3
n Trove or a ease , ?a -0036OR00060
00101
20-2