PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP81B00879R000500100022-6
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 2
• Document Creation Date: November 16, 2016
• Document Release Date: June 29, 1999
• Sequence Number: 22
• Content Type: FORM

B$ud.'.ai.ouYi .i~'ura>2IvTO. 1.0;4-Ituvisud - D. O. Von. No - --------------
Septelmbett 11R0-Mv
(?(Am Rog. No. February 20 lOil)I)
SERVICES OTHER THAN PERSONAL
U. U.S. --------------------------------------------------------------------------------------------------------------------------------
(Department, bureau, or establishment)
Voucher prepared at --------------------------------------------------------------------------------------------------------
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No. __-__--__--____-
To -------------------------------------------------------- 33y_con_ Mfg. Company_------------------------------------
(Payee)
------------------------- P&PAd nay,---oar= rnia------------------------
(Address) (City) (State)
ARTICLES OR SERVICES
UNIT
PRICE
AMOUNT
li
f D
(Enter description item number of contract or Federal supply
No. and Date of
very
Date o
e
S
i
schedule, and other information deemed necessary)
QUANTITY
Order
or
erv
ce
Discount Terms Invoice No .
Cost
Per
Dollars
Cts.
1536
78
oa
15347
40
15348
1,175
00
PAYMENT:
Complete F-1
Partial ^
Final ^
Use continuation sheet(s) if necessary
__
Shipped from to Weight Government
B/L No. Total
1,293
Dd
(Payee must NOT use this space)
I certify that the above bill is correct and just and that payment has not been received.
Differences --------------------------------
(Sign original only)
Date -------------------- *Payee ----S), oe,----?---goirod-en like?--o(ri, n attached bia or bill.)
(T61e aertlftoate not required whom a Ilk. certifioaLe is mode by payee o
,
Amount verified; correct for
F3
-----
0-0
I
Per -------------------------------------------- Title --------------------------------------------- (Signature or initials) ---------------------------------------
Contract No. Date Req. No. Date
Pursuant to authority vested in me, I certify that this account is correct and proper for p
25X1A9a
SIGN
ORIGINAL
ONLY
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown; other classification optional)
Check No- ------------------------ dated ------------------------------ 19-----, for $-------------------------------------- on Treasurer of the United States in
{ favor of payee named above.
Paid by I Cash, $------------------------, on ------------------------------------' 19-----. Payee ---------------- ------------ ---------------------------------------
(SLrn .,W..1 only)
me f,~t? o person
.When a voucher is r red or reeei c ijLthe n of a company r o r t'c hoa
writing Doe Company, toe p o company q
"Jo it 11 pi a; ? 7 p
n mi ere r o o e
t If the ability to certify and authority to approve are combined in one person, one signature only is nec-
essary; otherwise the approving officer will sign on the line below "Approved for $______-____________ , and
over his official title.
91-B0II87-9RcOO5OO'C00022=6------------
Title -------------------------------------------------------
 Approved For Release 2000/04/18 : CIA-RDP81 B00879R000500100022-6
METHOD OF OR ABSENCE OF ADVERTISING
1. Advertising in newspapers Yes ^ No [I.
2. (a) Advertising by circular letters sent to -------------------- dealers.
(b) And by notices posted in public places Yes ^ No [.
(If notices were not posted in addition to advertising by circular letters sent to dealers, explanation of such omission must be
made below.)
3. Without advertising, under an exigency of the service which existed prior to the order and would not admit of the delay incident to
advertising.
4. Without advertising in accordance with ---------------------------------------------------------------------------------------------------------------------------
5. Without advertising, it being impracticable to secure competition because of --------------------------------------------------------------------------
--------------------------------- ------------------------------------------------------
------------ ------------------------------------------------------------
----------------------------------------------------------------------------------
- - ------------- ---
d 4)
----------------------------------------------------------------------- - - - - -
e-- -,Ur which i:ho ho securing, of of competition was s impracticable under der 3 and
________________________
e stat
NOTE.-The above form "Method of or Absence of Advertising" is to be used when purchases are made or services secured under
proper authority without written agreement in any form. In case of a written agreement (formal contract, proposal, and acceptance, or
less formal agreement) Standard Form No. 1036-Revised should be used for abstracting the method of or absence of advertising and
award of contract. (See General Regulations No. 51, as amended.)
Approved For Release 2000/04/18 : CIA-RDP81 B00879R000500100022-6
0601W "P4