PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000600020118-4
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 2
• Document Creation Date: December 12, 2016
• Document Release Date: May 14, 2002
• Sequence Number: 118
• Publication Date: May 2, 1958
• Content Type: FORM

zr; worm prescribed by,U
Comptroller General. S. Approved
1950
tomhver 7
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(Gen, Reg. No. 51, Supp. No. 11)
(Amende(. February 20, 1952)
ERVI kloW
D. O. Von. No. - = --------- ----------- -
000600020118-0p9O.
Bu. Vou. No- ---------------------------------
U. S. ------- COST--REIMBURS
----------------------------------- ----------------------------------------------------------------------------------
(Department, bureau, or establishment)
Voucher prepared at --------------------------------------------------------------------------------------------------
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No_ ----------------
! V
c
CO}
1
To -----------------------------------------------------------------------------------------------------------------------------------
(Payee)
-----------------------------------------------------------------------------------
(.A ddress) (City) (State)
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
~J PAID BY
s_. O'7q
y ( OF 2,
UNIT PRICE
AMOUNT
Cost
Per
Dollars
Cts.
cost
39".
PAYMENT:
Complete ^
Partial ^
Final ^
d f
_ Use continuation sheet(s) if necessary
to Weight Government B/L No.
Total
3~
12
rom
Shippe
I certify that the above bill is correct and just and that payment has not been received.
.
(Payee must NOT use this space)
Differences ---------------------------------
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STATOTHR (sign original only)
------------------------- ---------------------
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