REQUEST FOR PAYMENT AND POSTING VOUCHER DAVID CLARK CO. INC
Document Type:
Collection:
Document Number (FOIA) /ESDN (CREST):
CIA-RDP67B00074R000500040006-3
Release Decision:
RIPPUB
Original Classification:
S
Document Page Count:
2
Document Creation Date:
December 21, 2016
Document Release Date:
December 11, 2008
Sequence Number:
6
Case Number:
Publication Date:
June 2, 1964
Content Type:
FORM
File:
Attachment | Size |
---|---|
![]() | 89.21 KB |
Body:
Approved For Release 2008/12/11: CIA-RDP67B00074R000500040006-3
142 REQUEST FOR PAYMENT AND POSTING VOUCHER VOUCHER NO. 7.12
Finance Division, Accounts Branch DIVISION VOUCHER NO.
Monetary Branch
1
,2
Request payment be made and/or transaction be recorded as indicated below. Pertinent documentation in support of
this transaction is on file in this office.
SUBJECT
INVOICE NO(S).
~= fa
PAYMENT TO
CONTRACT NO.
~
All 'NT
CHECK TO BE DATED
J
CASH PAYMENT
U.S. TREASURY CHECK
AGENT CASHIER CHECK
BANK CASHIER'S CHECK
THE ATTACHED CHECKS AND/OR CASH IN THE AMOUNT OF $ SHOULD BE TAKEN INTO ACCOUNT AS INDICATED BELOW.
I HEREBY AUTHORIZE MY AGENT. WHOSE SIGNATURE APPEARS BELOW. TO RECEIVE $ OF OFFICIAL FUNDS IN CURRENCY ON MY BEHALF.
DATE ISIGNATURE OF PAYEE
DATE
SIGNATURE OF AGENT
DATE
SIGNATURE OF RECIPIENT
DESCRIPTION-ALL OTHER ACCOUNTS 13-33
34-36
43
45-46
47-52
56.67
6411-70
26.33
STATION
40-4:
F
PAY
OBLIG.
53
54.57
ALLOT. OR COST
DUE
71.60
T/A NO.
CODE
EXPENC
U
PER.
REF. NO.
GENERAL
ACCT. NO.
DATE
AMOUNT
DESCRIPTION-
ADVANCE ACCOUNTS 13-27
P.O. NO.
PROP. NO.
CODE
N
LIq?
ADVANCE
ACCT
NO
CA
YR
LEDGER
62-67
CR. NO
OBJECT
D
COD!
.
.
ACCT. NO.
.
DEBIT
CREDIT
132-23
DIV.
PROJECT NO.
IT
S
EMP. NO.
X NSF. NO,
CLASS
J(,{{,~1 ~ t1 1 1
~1 Tll (~~ 1~
rl
I I
1 I
t
J
;.
_L
_
...f
~ ?y
SJ v / .L
U 02.
LL fJ A
I -1 1- T ITI
I
-
__I _I_y_I-I-I-1 I_J-I
L ~_I
_
t j
1 1
1 1
1 1
-I-1 I_J-1
I I
1 1
I I
I.
Az
`
74
1
V
1
~
~ V
t
V
1 1 1 1 1 1 1 1 1 1 1
25X1-
DATE
AUTHORIZED CERTIFY NG FFICER DATE
TOTALS
.r .,
3 ,.=~., ..
Approved For Release 2008/12/11: CIA-RDP67B00074R000500040006-3
Approved For Release 2008/12/11: CIA-RDP67B00074R000500040006-3
TO:' United States Government
Item Quantity Description
2 1 each S901F Flying Outfit
Size: Medium Short
(P/S D I066-794-M, 4/2/64)
2 1 each S901F Flying Outfit
Size: Small Long
(P/S D I072-794-M, 4/8/64)
3 1 each S901F Flying Outfit for -50
(P/S D 1143-794-M, 5/22/64)
Code No.: JAR-794-336
Invoice No.: D1151-794-3
voice Date: 28 May 6
ef. Contract No.: G1y7641
Project No.: 794
Terms: Net 30 days
14,000.00 14,000.00
$ 43,000.00
STAT
I certify that the above bill is correct and just
and that payment therefor has not been received.
STAT
tiI1NL 5l
Unit Price Total Price
$ 14,500.00 $ 14,500.00
14,500.00 14,500.00
Approved For Release 2008/12/11: CIA-RDP67B00074R000500040006-3