REQUEST FOR REIMBURSEMENT OR PAYMENT

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP87-01130R000100100032-4
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 5
• Document Creation Date: December 16, 2016
• Document Release Date: July 13, 2005
• Sequence Number: 32
• Publication Date: October 4, 1982
• Content Type: FORM

25X1
AWK?F Iefg@U3ft@jW2 : CIA-RDP87- 11'0 Ib'OO100032-4
111-
OR PAYMENT
ME OF CLAIMANT (LAST,FIRST,MIDDLE INITIAL) 4. EMPLOYEE NO. 5. OFFICE
Chairman/FAC 2
Johnson, Bruce T.
PAYABLE TO ROOM BUILDING AMOUNT
Bruce T. Johnson 2D00 HQS $5.62
6. PROJECT NUMBER 7. TYPE OF ADVANCE 8. IT NUMBER 9. DUE DATE
PURPOSE (FIRST 24 CHARACTERS OF EACH LINE WILL BE ENTERED):
lunch for Vincent Melzac
10. WHAT:
11. WHERE: EDR
12. WHEN: 2 August 1982
For the purpose of maintaining a working relationship on behalf
13. WHY: of the Fine Arts Commission with a noted art doner.
16. OBLIGATION REFERENCE NO.
14. EXP
15. AGENCY
CODE
CODE
TYPE
It
17.
LIQ
18.
I CERTIFY FUNDS ARE AVAILABLE
ORN S
UB
SOC
CD
AMOUNT
DATE
AUTHORIZED SIGNATURE
P
r r
AUTHENTICATION
S
$
DATE
SIGNATURE OF APPROVING OFFICER
S
CERTIFICATE FOR PAYMENT OR CREDIT
S
DATE
SIGNATURE OF CERTIFYING OFFICER
PAYMENT INSTRUCTIONS
DESIGNATION OF AGENT TO PICK UP FUNDS
I authorize my agent, whose signature appears below, to attire
$ of official funds on my behalf and acknowledge
therefor
when paid to
recei
t of such funds and m
responsibilit
CERTIFICATION (Check when applicable)
,
p
y
y
my agent.
REIMBURSEMENT
DATE
SIGNATURE OF AGENT
I certify that the disbursements itemized above were
en nor will I
t b
d
t I h
h
e
ave no
t
a
necessarily made by me an
DATE
O
SIG
T
R
L
T O
be reimbursed therefor from any other source and that this
NA
F C
U
E
AIMAN
R OFFICER
claim and attachments are true and correct.
^ PERSONAL SERVICES
t
ti
f
f
ACKNOWLEDGEMENT OF RECEIPT
The amount re
s
or sa
quested is due the payee
ac
ory
performance of du
rdan a with the terms o
f his
AMOUNT
CHECK NO.
contract or other
DATE
SIGNATI
DATE
SIGNATURE
0
1; 8
on
TRANS
CODE
5
-_
CODING AREA
MONETARY
CONTROL
AMOUNT
A
DATE
PREPARED BY EXT
DATE
REVIEWED BY
TOTAL
40RM 264 #01 T IONEIOU9 S RRFFr~[
Approved For R e a E1005/08T2 : PAE~f}P~`-&Ii8R0001ba18b '4COPY
 Approved For Release 2005/08/22 : CIA-RDP87-0113OR00010010O
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STAT
 Approved For Release 2005/08/22 : CIA-RDP87-0,1130R000100100032-4
EXECUTIVE r)INING ROOM'
Date
16 Milk -Coke -Ta $ .40
17 Juice - Coffee Tea.11.90. .40
18 Miscellaneous ................................... $
? tndudes salad
Membership
Izzu Na Ircw Pmts
1 Regular Lunch ' .............................. 5,3.85
O 2 Steak Delmonico Lunch ' ............... $5.40
O 3 Filet Sandwich ................................. $3.90
O 4 Steak Special ..................................... $2.75
D 5 Light Lunch ................................... $2.25
^ 6 Soup & Salad Bar ............................. 53.00
O 7 Salad Bar ONLY .............................. $2.25
O 8 Sandwiches ....................................... $2.25
^ ? Ham & Cheese -
O Roast Beef 0
^ Turkey /
^ 9 Eggs Begedict .................................. $2.25
^ 19 Omelet of the Week....; :.................. $2.25
O 11 -Low Cal ............................................ $2.25
12 Soup ............. ............................... $.75
^ ) i Salad-Vegetable ............................... $.45
14 Dessert ...................... ............... $.50
O 15 Chocolate Sundae ...... .................. $.60
Signature.
Room No.
Receipt Requested K
z
Approved For Release 2005/08/22 : CIA-RDP87-0113OR000100100032-4
 Approved For,, please 2005/08/22 : CIA-RDP87-0113@W00100100032-4
6. I certify that the attendance of the individuals listed
in paragraphs 4 and 5 is considered essential to the conduct of official
Government business and further, that the funciton will facilitate the
accomplish:aent of the DCI's duties and responsibilities.
7. The estimated cost of this function is $5.62
(*Exact cost of Mr. Melzac's lunch, according to the EDR staff.
No claim made for my own lunch.)
Chairman, Vine Arts Commission
Name and Titleof Requestor
STAT APPROVED:
A De ty irector or Head of Independent Office
27 SEP 1081
I certify the availability of funds in the amound indicated in paragraph 7.
paragraph 7.
Budget and Fiscal Officer, DCI
Executive Director
Approved For Release 2005/08/22 : CIA-RDP87-01130R000100100032-4
 'DD/A Registry
Approved For lease 2005/08/22 : CIA-RDP87-0113OW00100100032-4 ! Q,
16 AUG 1982
MEMORANDUM FOR: Executive Director
THROUGH : Deputy Director for Adminatstratinr(or Head of Independent Office)
I
Administrative Officer, DC
SUBJECT . Request for Approval to Incur Expenses Unde~
1. Approval is requested to incur expenses allowed and 1 -1
I believe the expenditure of appropriate funds is authorized
for the costs for fcx t"J , meals, c ad;=
on 2 August 1982 for the
,
purpose of maintaining a -working relationship ^^ h?raif ^f 't+?
Fine Arts Commission
3. Designated Official!/ and Persona present including their grade,
title, and orgarizational affiliation xbecc was:
Vincent Melzac, from whose personal collection have been
borrowed many of the art works on display in the
Headquarters building.
4. Other U.S. Government employee$ present including their grade,
title and organizational affiliation ma was:
I an, Fine Arts Commission
5. Other persons present including title and .nrgaaizationdl'affiliation
will be:
STAT
Approved For Release 2005/08/22 : CIA-RDP87-01130R000100100032-4
ADMINISTRATIVE - INTERNAL USE ONLY