REIMBURSEMENT VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP81-00755R000100080011-4
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: December 9, 2016
• Document Release Date: July 12, 2000
• Sequence Number: 11
• Publication Date: October 1, 1951
• Content Type: FORM

Approved or a ease 0/08/30 : CIq RpP81-0p755R000100080011-4
OUCHER"'
.. REIMBURSEMENT V
FOR PURCHASES AND SERVICES OTHER THAN PERSONAL
DATE l weber 1 ---
1. REIMBURSEMENT OR PAYMENT IS HEREBY CLAIMED FOR MATERIALS, SERVICES AND/OR EXPENDITURES ITEMIZED BELOW WHICH
ARE PROPERLY CHARGEABLE TO:
STATINTL
STA
ST#INTL 29 $ :
STAITI NTL Dims
ember 1951 - Sate
with covert agent =
NOTE: ATTACH RECEIPTS AND SUPPORTING DOCUMENTS AS REQUIRED.
2. I CERTIFY that the expenses itemized on this voucher and/or attached documents were necessarily incurred by me
in connection with official business of a confidential nature, and that I have not been, nor will I be, reimbursed
therefor from any source, Government or private; and that this voucher and attachments, if any, are true and cor-
rect in all respects.
STATINT.
UAIt
fur-
8. I CERTIFY that this voucher has been examined by me; that receipts or other that it substantiating appears data from such have been data that
nished me, or a satisfactory explanation made for the failure to furnish same;
the itemized materials, services and/or expenditures were for necessary official purposes, reimbursement or pay-
ment for which is allowable under existing regulations; and that such expenditures are properly chargeable to
available appropriations as indicated below.
ALLOTMENT AUTHORIZED CERTIFYING OFFICER
DATE APPROPRIATION
5. ACKNOWLEDGMENT OF RECEIPT
RECEIPT IS HEREBY ACKNOWLEDGED OF $
Approved For Release 2000/08/30 : CIA-RDP81-
DATE
M008=1 --4-