RECEIPT

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000700050019-0
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: December 9, 2016
• Document Release Date: March 20, 2000
• Sequence Number: 19
• Publication Date: October 3, 1959
• Content Type: FORM

STATINTL
Approved For ??se_20 ILOEL 5 (IA-P P6-00360 000700050019-0
QUEEN ANN MOTEL
Phone ORchard 5-2042
R~r'cIpT
UNITED AIR LINES VC.
Vor Conditions of Contract See Passer._,?Picket
& Baggage Check
VALUATION CHARGE
On Above Declared Vdu.
PREVIOUSLY PD. VAL. CHGE.
BALANCE OF VAL. CHGE.
TOTAL WEIGHT lba
FREE ALLOWANCE
and prevtouely JbR
Pd. Exc. Wt
? ?
PASSENGER TICKET
FORM t NO.
EXCESS WT. CHGE. Q Per lb. --Cy.
EXCESS WT. CHGE. @~ rr p?r Ib. Cy.
TOTAL CHARGES /-' Cy.
TAX - Cy.
TOTAL PAYMENT zj c' r 7 criy.
r r
166
42
v;?~.44
Approved For Release 2001/08/15 : CIA-RDP64-0036OR000700050019-0