PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000600040072-3
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 2
• Document Creation Date: December 9, 2016
• Document Release Date: June 2, 2001
• Sequence Number: 72
• Publication Date: June 23, 1959
• Content Type: FORM

Standk%rd Form No. 1034---Rovised
1*orm prescribed by
yr
Comptroller Q 7, 195 I S, - 0 T
September 7, 1950 Q proved F aTY/gli ?~7Y(7-j
(Qen. Reg. No. 51, Supp, No-. I~
(Amended February 20, 1052)
FFnp - D. O. Vou. No- -------------------------------
11Y. C IM ~O Qb~000600040072-3
ER THAN PERSONAL Bu. Vou. No. -___-_
---------------------------
U. S? -----------------------------------------------------
-------------------------------------------------------------------------
(Department, bureau, or establishment)
Voucher prepared at -------------------
------------------------------------------------------------------
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No. ____---__-_____-
To ________-- ~~'hornson Rama Wooldr9.dae, Inc .
- - - - ---------------------------------------------------------------
(Payee)
----------------Zos Angeles i~~ California
!A AAraecl _ ___________________________________________________________________
ARTICLES OR SERVIC
No. and Date of
Order
Date of Delivery
or Service
ES
(Enter description item number of contract or Federal supply
schedule, ands other information deemed necessary)
QUANTITY
UNIT
PRICE
AMOUN
T
-
Discount Terms
Cost
Per
Dollars
Ct
s.
Voucher nos:
2418
24~1g
~+
(4, 94-5
98
2+20
15., 478
24-21
16, 876
85
24.22
4
1
9, 2774
69
'AYMENT:
2
23
4
9
i , { 88
06
Complete ^
2431
88, 090
31
Partial ^
Ap
d For Release 2001/08/15: CIA-RDP64-003
OROO
60004
072-3
(985
89)
Final ^
24.33
(157
-
Use continuation sheet(s) if necessary
(250
15)
t
o Weight r ~.,r e 4 a n rt
_-
)
)
 ?9taaidttr'tJ Form. No. 1034-Revised t~ii
lormproscribed
~
~
~~~
~~~rOVed For R
S
21
ComSpePtelmbor 7 e 196 .
((3en. Reg. No. 51, 0upp. No. 11) SERVICES ~
(Amended February 20, 1962)
60004307-3
Bu. ou. o- ---------------------------------
- (Department, bureau, or establishment)
- - ---------------
Voucher ~re~ared at ------------------------
------ (Give place and date) -
THE UNITED STATES, Dr., Payee's Account No. ________________
To --------'I'non)pson _Ramo__t~Tool.dsid~e z--Inc .---------------------------------------------------------------
- (Payee)
-------------------
------------------------------------
Los A -
---- - ----------------------------- (State)
-----------------------?-'geles 5, dal orna.a ---------
(City)
No. and Dato of
Order
(Address)
Date of Delivery
or Service
(Enter description item number of contract or Federal supply
schedule, andr other information deemed necessary)
Discount Terms
on hued:
PAYMENT:
Complete ^
Partial ^
^
1,513
9~-5
13,56
7f
31
62
62
~-~E
37
tie, 132
Final
I ~ =
to Weight Government B/L No. ~ Tota~i
Shipped from ~ (Payee must NJT use this space)
I certify that the above bill is correct and just and that payment has not been received.
-------------------------
Date ____________________ ayes (This cortiflcate net rogalred when alike cerilsrete fe made by payeewattaohed bia or bills)
--------------------------
Per -------------------------------------------- it e --------------------
Contract No. ~-1iJa. Date
Pursuant to authority vested in me, I certify that this accounSTATINTLproper for pa
t APProved for $ --------------------?-------------
SIGN
ORIGINAL
ONLY
Differences ---------------------------------
Amount verified; co
4Signature or initial:
0
~, 7 5
35
--------------- -----
__ STAT_lN _L_
Date Invoice Recd.
Date ------------------------------------------------------------------------
Title ----------------------------------------------------------
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 bo shown; other classification optional)
Check No. ------------------------ dated ___________------------------. 19____-, for $_________----------------------------- on Treasurer of the United States in
{ favor of payee named above.
Paid by 19 Payee ---------------------------------------------
_____________________________ (t;lan orlRlnal only)
Cash, $------------------------? on --------
*When avoucher is t,r.a o o a co~~ t dor~~ho name of the person _ _____________________________________
writingthecompany~~~"l l~et'~~3n4~5V~~t~Dt~3 X000600040072-3 18
"John Dao Company, per John Smith, Bocretary", or "Treasurer", as the case may e. Title _________________________________________
i -- -----------
t If the ability to cent fy and authority to approve are combined in ono person, one signature only is nee- - -
essary; otherwise the approving officer will sign on the line below "Approved for $________________ ", and -zzooo-s
recr his official title. .. ~^
2.35
x+39
2~~~-3
x+66
2!~~8