REQUEST FOR PAYMENT AND POSTING VOUCHER

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP67B00539R000700050033-4
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 5
• Document Creation Date: December 21, 2016
• Document Release Date: December 31, 2008
• Sequence Number: 33
• Publication Date: March 13, 1962
• Content Type: FORM

VOUCHER NO. 7-12
REQUEST FOR PAYMENT AND POSTING VOUCHER
VOUCHER NO 7-12
TO : Finance Division, Accounts Branch {
DIVI*ION VOUCHER NO. `
Branch I
monetar
~ ~~
3
y
THROUGH:
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). A 25'. 2.
PAYMENT TO
CONTRACT NO. c}
?
AI( =tT
F72 A I %j of:
r
CHECK TO BE DATED
o
_
CASH PAYMENT
U.S. TREASURY CHECK
AGENT CASHIER CHECK
BANK CASHIER'S CHECK
THE ATTACHED CM AND/OR CASH IN THE AMOUNT OF S SHOULD ^E TAKEN INTO ACCOUNT AS INDICATED BELOW.
I HEREBY AUTHORIZE MY AGENT. WHOSE SIGNATURE APPEARS BELOW. TO RECEIVES OF OFFICIAL FUNDS IN CURB Y ON MY BEHALF.
DATE
SIGNATURE OF PAYEE
DATE
SIGNATURE OF AGENT
DATE
SIGNATURE OF RECIPIENT
DESCRIPTION-ALL OTHER ACCOUNTS 13-33
34-39
43
45-46
47-52
OSLIG
55-67
65-70
71-SO
>M-33
STATION
40-43
F
PAY
.
53
54-57
ALLOT. OR COST
DUE
AMOUNT
T/A NO.
CODE
EXPEND
-[R
REF. NO.
GENERAL
ACCT. NO.
DATE
DESCRIPTION-
ADVANCE ACCOUNTS 13.17
P.O. NO.
PROP. NO.
CODE
N
.
LID.
ADVANCE
ACCT. NO.
CA
YR
LEDGER
NO
ACCT
63-67
CK. NO.
OEJECT
DEBIT
CREDIT
oI
PROJECT NO.
0
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CODE
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CLASS
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PREPAR
DATE
AUTHORIZED CERTIFYING OFFICER
DATE
TOTA
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4 6RIM 1822
Approved For Release 2008/12/31: CIA-RDP67B00539R000700050033-4
(When Filled In)
8E
Approved For Release 2008/12/31: CIA-RDP67B00539R000700050033-4
 Standard Fenn No. 1034
7 GAO 5030
'34-106
Approved For Release 2008/12/31: CIA-RDP67BOO539ROO0700050033-4
PUBLIL. VUULHLK FUK ruKLnA3L3 Amu
SE: CES OTHER THAN PERSONAL
Contract No. HF-CT-691
Shipped from
No. and Dote of
Order
Data of Dollvory
or Service
Req. No.
Weight
Date Invoice Recd.
Govt. B/L No.
ARTI ES OR $ER I
Enter description, Item number of contract or Fodoral supply
schedule, and ether Information deemed necessary)
Inv . Noe.
90-6503/6400-21
90-6503/6400-22
COMPLETE
PARTIAL
FINAL
PROGRESS
ADVANCE
(PAYEE MUST NOT USE THIS SPACE)
Amount verified; correct f
(Signature or initials)
t Approved for
By
Title
Exchange rate =$1.oo
THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE
Check No. on Treasurer of the United States
Check No. on
Paid by (Name of Bank)
$ , on 19 Payee
Cash
,
When used in foreign countries, insert name of currency of country in which used.
t If the ability to certify and authority to approve are combined in one person, one signature only is nec?
essory; otherwise the approving officer will sign on the line below "Approved for $ and
over his official title. Title
Approved For Release 2008/12/31 : CIA-RDP67BOO539ROO0700050033-4
$)+, 939.57
30.00
Pursuant to authority vested in me, I certify that
payment.
STAT
139 BR STAT
(Dote)
atracting officer)
 Approved For-Release 2008/12/31 : CIA-RDP67B00539R000700050033-4
- - - -- ----------
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DPD- IC to - C z,
COPY a OF j
STAT
DATE ORDER RECEIVED
-
CUSTOMER'S PURCHASE ORDER NO.
Common Custorm r
SCHEDULED SHIPPING DATE
SALESMAN
INVOICE NUMBER
_
LIE-cl-(191
80
90-650316400-21
SHIP VIA
F.O.B. POINT
DATE SHIPPED/INVOICE DATE
CARRIER'S RECEIPT NUMBER
2/16/62 3/7/62
QUANTITY
DUE
SHIPPED
TODAY
MODEL/PART NUMBER
DESCRIPTION
UNIT PRICE
TOTAL
PRICED EXHIBIT NO. 5--COMPLETED
BILLING AGAINST PACKING LIST. NO. 3
6
PER ATTACHED:
4
4
ITEM 4, BA-BR44-388
39.38
37.52
10
10
ITEM 5, BA-BR44-40
356.90
3,569.00
3
3
ITEM 8, BA-10634-481
444.35
1,333.05
AMOUNT SUBMITTED FOR REIMBURSEM
NT
4,939.57
CY
We certify that the above bill is
correct and just; tht payment therefor
has not
STAT
ler
SELLER REPRESENTS THAT WITH RESPECT TO THE PRODUCTION OF THE ARTICLES AND/OR THE PERFORMANCE OF THE SERVICES COVERED BY THIS
INVOICE IT HAS FULLY COMPLIED WITH SECTION 12 Al IOF THE FAIR LABOR STANDARDS ACT OF 1938. AS AMENDED
33 Uni.ersity Road, Cambridge 38, Ma..achusetts
ANALYTICAL & CONTROL
INSTRUMENTS
Approved For Release 2008/12/31: CIA-RDP67B00539R000700050033-4
 Approved For Release 2008/12/31: CIA-RDP67B00539R000700050033-4
Baio, Georgia
rep 1ON i
Pac k ng list
DaLe ___...___Ijk A-
WaybAl No
Carr.'.--r -- j, _ut- ter&STAT
Y cur raqu-ML no ?+N>
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3.
Cambridge 48, ?
11 . be"j SUPP"
$A-*IM"-2M
BA--M"040
SAeI*Wo S1
-& -a -w*ftitia lit w arose.
of ra r P jpt
STAT
L Ora IT/poi
Approved For Release 2008/12/31: CIA-RDP67B00539R000700050033-4
;~;t;Krr hus tt
 Approved For Release 2008/12/31 : CIA-RDP67B00539R000700050033-4
a, -- W mw ANALYTICAL & CONTROL
Bird 33 Un, rsity Road, Cambridge 38, MG ach.useps INSTRUMENTS
Aiowssit
WASHINGTON, D. C.
STAT
""I` ""?`K ""`I"`? ommon ti mer (
or ei.`y r,-d'a t
r
INVOICE NUMBER
HF-CT-691
80
90-6503/6400-22
SHIP VIA
F.O.B. POINT
DATE SHIPPED/INVOICE DATE
CARRIER'S RECEIPT NUMBER
2/19/62 3/7/62
QUANTITY
TODAY
MODEL/PART NUMBER
D E S C R I P T 10 N
UNIT PRICE
TOTAL
PRICED EXHIBIT NO. 32--COMPLETED
BILLING AGAINST PACKING LIST 399
PER ATTACHED:
40
40
ITEM 2, AR44-395
.75
AMOUNT SUBMITTED FOR REIMBURSEM
NT
30.00
G1
We certify thet the chore hill is
correct :~;,;~ th it. N~ iy'1 Lt therefot
has no
INC
.
STAT
SELLER REPR
ESENTS T
HAT W
T
B
I
H RESPECT TO THE PRODUCTION OF THE ARTICLES AND/OR THE PERFORMANCE OF THE SERVICES COVERED BY THIS
INVOICE IT HAS FULLY COMPLIED WITH SECTION 12 (Al OF THE FAIR LABOR STANDARDS ACT OF 1938. AS AMENDED
TELEPHONE: UNIVERSITY 4-7420 - CABLE: BAIRDCO Cambridge, Massachusetts, U.S.A. TERMS: NET 30 DAYS
Approved For Release 2008/12/31: CIA-RDP67B00539R000700050033-4