PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000600040065-1
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 3
• Document Creation Date: December 9, 2016
• Document Release Date: June 2, 2001
• Sequence Number: 65
• Publication Date: May 26, 1959
• Content Type: FORM

Gitandard i'oTTU N,~. 11Y.t~1~-iit~cised D. O. Vou. tvo. --------- ---------------__
~'~~~~~','r?"'r''"'`""' AY1Y1 roved F81tIB.~I~a~?tdQ~I~8Ffl6R L'I~,~OO~~bR000600040065-1
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cG:n. lteg. No. ,t, 5n,,,,.:.e. lu SER`4'ICES OTHER THAN PERSONA,. Bn. ~o~. No. ________?____9_____________
(Amonded Fcbruaey 2J, 1ir52)
U. S. -----J ~; sT ~ zh~~uY,sP Bra
- - -------------------------------------------------------------------------------------
(Department, bureau, or establishnnnt)
Voucher prepared of ---- ----------------------------------- ---------------------------------------------------------
(Gi~~c place and date)
THE UN[TED STATES, Dr., Payee's Account 1Vo_ ________________
To -----------------------------------------------------------------------------------------------------------------------------------
(Pa>-ee)
(Addrr~s) _ (City) __ (3tate)
No. and Date of
Order
Date of Delivery
or Service
ARTICLES OR SF. F2~'ICES
(Enter description, item number of contract or Federal supply
schedule, and other information deemed nece+sary)
Discount Term+
PAY[vtENT:
Complete
Partial
Shipped fror~,
Use continuation sheet(s) if necessary
Weight Government Bi L No.
qp~- ~ l` %-2%
Total
1 herttfy that the above bil4is aorrect and just and that payment has not been received. -
TATINTL Diffcrences _________________________________
(Sign original only) -------------------------------------------'-
2,187
- --------- -----
Date __ 2 -2 ------------------------ --------------------------------------------- /E --
------------------- fj
? like oereiGc.[e ie m~da br Dares on etteabed bia or bill.) ~l / .I'~
Amount venfied; correct for ___________ -~_
Per _ - --- - --- -- --- ---- - - ---- ------ (Signature or initials) ~_~~------- -- ------------------
- - --- - -- -- -- - ~
llate tnvorce Icec a.
Pursuant to authority vested in me, 1 certify that this account is correct and proper for payment.
SIGN
ORIGINAL
ONLY
----------------------------------------------------
- -~------------------ (Authorised Certifying OtTicer)
Title Date . _ -------------------------------------------------------------------
TNE REVERSE OF THIS FORM MUST BE E%ECUTED WHEN PURCHASES ARE MAllE OR SER19CE5 SECURED R'I'rHOUT WRITTEN AGREEMENT IN ANT FORM
- - --- ---
ACCOUNTING CLASSIFICATION (Appropriation Symbol mint be shown; other cla++ification optional)
f Cl1GClt No. on Treasurer of tht United States in favor of
!Il dated 19 .for $------ --------------------------
----------- -------- ------------------------' payer named above
Paid by
Cash. S _ - _. on ---- 19 Payee ---- - ----------------------ia~.o o.,~~?ni o~i>i -----------------------------
? Wben avoucher is signed or recripted in the Horne of a company or corporation, thr~!u:rue of the person Per -- ---- --------------------------------------------------------?
writing tho compuny or corporate name., as well as the capacity in wi,ich he signs, must appear. Forexaruple:
"John Doe Company, ]~cr Juhn Ernith, Secretary", or "1`reasurcr", as the eau; may be.
f ll rho ability to certi[y and a thorn ~ to n > ore ~ m ^ed iu o e ~ r ~ u s'>uaturo onl Is uec- _ ___________________________.
esaary, oth~rw-rs~ Iha appr~vin~~'a-v~~`~'miL 'e>~~~setf~f~~l~k~~1~ -CIA-I~~t~~9 -0036 OODBai~0~66~~-1 ta--~t~no-tr
over hie ot-cial title.
 Approved For Release 2001/08/15 :CIA-RDP64-003608000600040065-1
Approved For Release 2001/08/15 :CIA-RDP64-003608000600040065-1
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