PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000600040057-0
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 2
• Document Creation Date: December 9, 2016
• Document Release Date: June 2, 2001
• Sequence Number: 57
• Publication Date: May 21, 1959
• Content Type: FORM

(Standard ]Term No. 1032-Revised {~{.ry~
Form proscribed by Approved For p E"V1D@Gl'1~3~pp~p8y'!)*1C ~,, M~0 60R00 t (Y'02t(b57 0_-__.._-_-_.-______-_...._
Comptroller General, U. S.
So0ember 7, 1950 II''
(Gen. Reg. No. 51, Supp. I`~. 11) 'SERVICES OTHER THAN PERSONAL'' Bu. You. No. --___-_-_-_ 2` 63___-____--_ _
(Ainended FebZ'tary 20, 1952)
U. S. COST REIMBURSABLE
-- ---------------------------------------------------------------------------------------
(Department, bureau, or establishment)
Voucher prepared at -----------------------------------------------------------------------------------------------------
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No. ----------------
To ------------------------ -------------- ---------------------------------------------------------------- ------------------- ------
(Payee)
-------------------------------------------------------------------------------------------------------------------- ------------ ------
Shipped Erom to Weight Government B/L No. Total
(Payee must NOT use this space)
.
1 certify that the above bill is correct and just and that payment has not been received
STIATI
NTL
No. and Date of
Date of Delivery
ARTICLES OR SERVICES
(Enter description, item number of contract or Federal supply
QUANTITY
UNIT PRICE
AMOUNT
Order
or Service
schedule, and other information deemed necessary)
Di
scount Terms
Cost
Per
Dollars
EYS.
Cost
$1645
PAYMENT:
Complete ^
Partial ^
Final El
Use continuation sheet(s) if necessary
16
45
Differences --------------------------------
(Sign original only)
Date ------ ---------- ---------------------------------
d when alike eortifioote f, made by payee on attached bill or bills)
-----------------------------------------------
---------------
Amount verified; corre for ___________
By ------------------------------------------------------------
SIGN
ORIGINAL
ONLY
(Signature or initials) -------------- ___________
Date Invoice Recd.
t --------- ----------=--------------------------------------------
(Authorized Certifying Officer)
Title ---------------------------------------------------------- Date -----------.-.----__----------? -----------------------------------
TIiE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
* When a voucher is signed or receipted in the name of a company or corporation, the name of the person
writing the company or corporate name, as well as the capacity in which he signs, must appear. For example:
"John Doe Company, per John B~( NOW E16 i s ps, he)gq~q app Q
f If the ability to certify and autllelN~sff1 Ar?JAi~d&i ~Se igeMWt,'dil4 (gis ure i9 ~bc~
essary; otherwise the approving officer will sign on the line below "Approved for $------------------ '; mid
over his official title.
I Check No- ________________________ dated ------------------------------ 19 ------ for $--------------- .--_._-_.-___-..-_.--_______ Jon Treasurer of the United States iu lave., m
Paid by f lpayee named above.
` Cash, $ - on 19 Payee ---
(ai?a erislnal only)
Per --------.-----_.--------------------------------------
64-00 0R000600040057-0
------------------------------------------------
q Z4 11 as AVW
 Approved For Release 2001/08/15 : CIA-RDP64-0036OR000600040057-0
Approved For Release 2001/08/15 : CIA-RDP64-0036OR000600040057-0