DISBURSEMENT BY TREASURY CHECK

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP81B00879R001100040014-5
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 5
• Document Creation Date: December 23, 2016
• Document Release Date: May 8, 2014
• Sequence Number: 14
• Publication Date: February 26, 1960
• Content Type: MF

Declassified in Part- Sanitized Copy Approved forRelease2014/05/08 : CIA-RDP81B00879R001100040014-5
844-11-8-Pr
rben filled in)
VAtelver no. $85
26 r wait, ay 19 643,
MRAIRAMP4 roR Vhier, Finance DI /Onion
ATTENTION Ivbastary Branch
.1.%1BJECT Distaxiseent by Treasury Check
It is kindi$ requested that a Cr. 3. Treasury Check be drawn in
rev= of the eampsuy listed hereunder in the amount stated, vhiCh will
applicable to the contract or egreament shown. The contract number
and tavoice identification must appear on the check.
ialette dream in favor of :
Amountll
Oontreat tumber:
lowrnies Rusiben
71.aaaX to be dated:
1,4rtinent documentatical in connection with this classified
transact:ton uhl has not been included in -accordance with Comptrollers
I7-letructiott *a, 32 the Office of the Cieptroller; DPD-DD/P.
Tho payment requested is hosed on progress mode 'by the Contractor
ana obou.11 he processed againet General Ledger Account
tttlopl '1Vabursoment of J4,propriated nmds Chargeable to Confideatial
;..i.10-reenta Awaiting DC/ Certifieation." The allotment nriabol
'mAlt_lettpie to this ref:pest la aim endtM mnunt
,e6,,,,c,Ateur,le to tieneT1L1 bredaaiTV
'The ilback should be dated as stated in 'Paragraph 1 sal.
,..1,- 4ttaated aelt--addresssed b envelope.,7
oul ,% : i' A. Cm? attemshets,
whd, e cc/At:tett d .4 /seat
? rm.. alopositlon.
SY T28
Dist:
2 -Addressee
LX- Contract BB 300 .(Posting)
1 - libuCherFile
HEB:nh/DPN0Fin/26 Feb. 60
DOCUMENT NO.
NO CHANGE CHANGE IN CLASS.
D DECLASSIFIED
CLASS. CHANGED TO:
NEXT REVIEW DATE: TS S
AUTH: HR 7O
DATE :1 FiEViEWER: 919956
?
50X1
50X1
Declassified in Part- Sanitized Copy Approved for Release 2014/05/08: CIA-RDP81B00879R001100040014-5
Declassified in Part- Sanitized Copy Approved for Release 2014/05/08: CIA-RDP81B00879R001100040014-5
Form prescribed by
? Compkoller General, U. S. "UBLIC VOUCHER FOR l'UKCHAStb P-1
September 7, 1950
(Gen. Reg. No. 51, Supp. No. 11) *lie SERVICES OTHER THAN PERSONAW
(Amended February 20, 1952)
U.S.
(Department, bureau, or establishment)
Voucher prepared at
(Give place and date)
Payee's Account No.
Corporation
Bu. Vou. No.
THE UNITED STATES, Dr.,
To
(Payee)
Boston, Massachusetts
PAID BY
Cit
State
No. and Date of
Order
Date of Delivery
or Service
ARTICLES OR SERVICES
(Enter description, item number of contract or Federal supply
schedule, and other information deemed necessary)
Discount Terms
QUANTITY
UNIT PRICE
AMOUNT
Cost
Per
Dollars
Cts.
Supplemental No.
21 Release of Patent Righ,
s
$5,000.00
& Royalties
31
10,890
81
PAYMENT:
Complete ?
Partial il
Final ?
Use continuation sheet(s) if necessary
Shipped from to Weight Government B/L No.
Total
*15,890.81:
(Payee must NOT use this space)
I certify that the above bill is correct and just and that payment has not been received.
STAT
Differences
(Sign original only)
Date *Payee
(This cer)ifloate not required when a like certificate ie ende by payee on attached bill or bills)
Amount verified; correct for
/5-i9e
P
Per Title
(Signature or initials)
Contract No. ig3 300 Date Req. No.
Pursuant to authority vested in me, I certify that this account is correct and proper for payment
f Approved for $
Date
By
Title
? SIGN
ORIGINAL
ONLY
Invoice Reed.
L.
Title jrne
N
Date
THE REVERSE OF THIS FORM MUST RE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown; other classification optional)
STAT
Check No.
Cash, $ on- dated
, 19 .
19 for $
Paid by
f on Treasurer of the United States in
I favor of payee named above.
Payee
(Sign original on(y)
??????=?Nes?
When a voucher is signed or receipted in the name of a company or corporation, the name of the person
writing the company or corporate name, as well as the capacity in which he signs, must appear. For example:
"John Doe Company, per Sohn Smith, Secretary", or "Treasurer", as the ease may be.
t If the ability to certify and authority to approve are combined in one person, one signature only is nee-
Title
the line below "Approved for $ ", and
15-22000-5
Declassified in Part -Sanitized Copy Approved for Release 2014/05/08 : CIA-RDP81600879R001100040014-5
Per
Declassified in Part- Sanitized Copy Approved for Release 2014/05/08: CIA-RDP81B00879R001100040014-5
METHOD OF OR ABSENCE OF ADVERTISING
METHOD OF ADVERTISING
1. Advertising in newspapers Yes 0 No 0.
2. (a) Advertising by circular letters sent to dealers.
(b) And by notices posted in public places Yes 0 No 0.
(If notices were not posted in addition to advertising by circular letters sent to dealers, explanation of such omission must be
made below.)
ABSENCE OF ADVERTISING
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
(Here state in detail the nature of the exigency or circumstances under which the securing of competition was impracticable under 3 and 4)
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.)
16-22900-2 0. s. GOVERNMENT PRINTING OFFICE
Nod
Declassified in Part - Sanitized Copy Approved for Release 2014/05/08: CIA-RDP81B00879R0n11nnn4nn14_g
? Declassified in Part - Sanitized Copy Approved for Release 2014/05/08: CIA-RDP81B00879R001100040014-5
1INt V I
Itek =4"-- Itek CorporatVin
BOSTON
SOLD TO:
SHIPPED TO:
Waltham 54, Massachusetts
INVOICE DATE/ 2/11/60
INVOICE NO.
31
terms, net cash
YOUR ORDER NO.
GOV'T CONTRACT NO.
,43/2 3 C.S ef>
SHIPPED VIA-
9005
PERIOD COVERED - INCEPTION THRU 1/31/60
DIRECT LABOR
OVERHEAD
MATERIALS
SUB-CONTRACT
OTHER.DIRECT COSTS
TOTAL MANUFACTURING COST
GENERAL ADMINISTRATION
TOTAL
PREVIOUSLY BILLED BY ITEK
NET AMOUNT DUE
I CERTIFY THAT Tit ABOVE B1 L IS CO -AND OUST
AND THAT PAYMENT HAS NOT BEEN RECEIVED. PAYMENT
IS REQUESTED ON A PROVISIONAL BASIS PENDING THE
ESTABLISHMENT 05-ACCEPTED OVERHEAD RATES.
STAT
STAT
TREASURER
094 ila Lti I 91 93J
Declassified in Part- Sanitized Copy Approved for Release 2014/05/08: CIA-RDP81B00879R001100040014-5
STAT
Declassified in Part- Sanitized Copy Approved for Release 2014/05/08: CIA-RDP81B00879R001100040014-5
R
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