PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000600040018-3
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 2
• Document Creation Date: December 9, 2016
• Document Release Date: June 2, 2001
• Sequence Number: 18
• Publication Date: July 30, 1959
• Content Type: FORM

?kandard Fdinn No. 7024-itevised
Foam prescribed by
a'ilnptiUller Ci I U S . D. O. Vou. No- ---------------------------
.
Septembere1 eirWa11 6Ved For Rele ul-INIAR l tc# OZ40018-3 2+92
(?T;non
d Febru a 20,1962)' )
. RVICES OTHER THAN PERSONAL Bu. Vou. No. _
---------------------------- ----
To
U. U.S. --------------------- ---------------------
-------------------------------------------------------------------
(Department, bureau, or establishment)
Voucher prepared at
- ----- -----
---------------------------------
------------------
(Cive place and date)
THE UNITED STATES, Dr., Payee's Account No. ----------------
--------------- ----------------------------------------------------------
(Payee)
(City) (State)
No. and Date of
Order
ARTICLES OR SERVICES
(Enter description item number of contract or Federal supply
schedule, and other information deemed necessary)
Discount Terms
PAYMENT:
Complete ^
Partial ^
Final ^
Date of Delivery
or Service
Shipped from to Weight Government 13/L No. I Total
I certify that the above bill is correct and just and that payment has not been received. i (Payee must NOT use this space)
Date ---- 7=39
----------------------------------------------
Contract No. / d / Date Req. No.
Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
t Approved for $ -----------------------------------
SIGN
ORIGINAL
ONLY
-----------------------------------------------
------------------------ ----------------------
-----------------------------------------------
Amount verified; corre
(Signature or initials)
Date
$(3,022
211)
---------------
---------------
---------------
-------------
j 2
t -----------------------(Authorized Certifying Officer)
Title
Title ---------------------------------------------------------- Date -------------------------------------
----------------------------------
THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENTJN ANY FORM
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown; other classification optional)
I Check No- ________________________ dated ___-___---__-____-___---__--_ 19 ,for $ fon Trasurer of the United States in favor of
Paid by ------ -------------------------- ipayeeenamed above.
Cash, $-----------------------
? on ------------------------------------1 19-----. Payee ------------------------------- -------- onl--y> ------------------------------
" When a voucher is signed or receipted in the name oY a company o c o th e r o (Sign orlginei
writing the company or per 9dM~FShiitII, bLr taT o r asure?rrr as t e case may bo.
t If the ability to certify and authority to approve are combined in one person, one signature only Is nec- Title -------------------------------------------------------
essary; otherwise the approving officer will sign on the line below "Approved for $ ---------------- and
over his official title.
10--22500-6
 Approved For Release 2001/08/15 : CIA-RDP64-0036OR000600040018-3
Approved For Release 2001/08/15 : CIA-RDP64-0036OR000600040018-3