PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000600020034-7
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 2
• Document Creation Date: December 12, 2016
• Document Release Date: May 14, 2002
• Sequence Number: 34
• Publication Date: July 23, 1958
• Content Type: FORM

!! F"im let Gener~d by
_ omptro llor Gonera l, u U. S S.
a Approv e WoXQV ,
r 7 1950
b
t
em
e
- Sep
SERVICES
(Gen. February 0, 19No. 52)11
- OR0006000200O~
Bu. Vou. No- -------- -----------------------
U. S. ---eD.?_-B=U25A= _ -------------------------------------
----- ---------------------------------------------
(Department, bureau, or establishment)
---------------- ----Voucher prepared at (Give place and - date)
THE UNITED STATES, Dr., Payee's Account No_ ----------------
TO -------- ---------------------------------------------------- ---------------------------------------------------------
-------Payee)-- ---
No. and Date of
Order
Date of Delivery
or Service
ARTICLES OR SERVICES
(Enter schedule, and othertinformation supply
denied necessary)
Discount Terms
PAYMENT:
Complete ^
Partial ^
Final ^
Shipped from to Weight Government B/L No. I Total
(Payee must NOT use this space)
I certify that the above bill is correct and just and that payment has not been received,
Date
-------------------------
fleas nos required whop n Pks eertlacsse 1. male by notes en set.nhed bill or bill.)
Per ---------- Title ------------------------------------ --------
Contract No -/d/ Date Req. No.
Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
SIGN
ORIGINAL
ONLY
(79945
(7:9k
---------------
---------------
---------------
(Signature or initials) -_- k_-------------------------------
Date Invoice Recd.
- - - - --------- ---------
-----------------------
(Authorized Certifying Officer)
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.
Paid by
--------------
Cash, $ ----------------------- -- on ----- 19 Payee ---------------------------- -----------------------------
ca>ee nriainal odr)
? When a voucher is signed or coi ted* n the~R a of co pany or C0910 ration the name of the person e _____________________________________
E
RDPE -e 03
aki~t'fieargs
writing the company or corporat~dnti re
"John Doc asuror , as o e a b .
Company, per John S )t ,Secretary' or `
tIf the ability to certify and authority to approve are combined in one person, one signature only is nee- Title _______________________________________________________
essary; otherwise the approving officer will sign on the line below "Approved for $___________________' , and rs-zzsoo-s
over his official title.
 STATOTHR
L Approved For Release 2002/06/10 : CIA-RDP64-00360R000600020034-7
Approved For Release 2002/06/10 : CIA-RDP64-00360R000600020034-7