FOIA
PUBLIC VOUCHER FOR PURCHASES SERVICES OTHER THAN PERSONAL
Document Type:
Collection:
Document Number (FOIA) /ESDN (CREST):
CIA-RDP81B00879R000100050006-4
Release Decision:
RIPPUB
Original Classification:
K
Document Page Count:
2
Document Creation Date:
November 16, 2016
Document Release Date:
July 21, 1999
Sequence Number:
6
Case Number:
Publication Date:
September 16, 1959
Content Type:
FORM
File:
| Attachment | Size |
|---|---|
 CIA-RDP81B00879R000100050006-4.pdf | 102.34 KB |
Body:
~~
bbrm prescrroea Dy
en)ptrollgU- VrgbWd For
.p', upp. No. 11)
(Gen. neg. No. 1,
(Amended February 20, 1962)
19R000100050006-4
RS AT, A Bu. Vou. No- ---------------------------------
PaRe1of1
U. U.S. ----------------------------------------------------------..--------------------------------------------------------------------
(Department, bureau, or establishment)
Voucher prepared at --------------------------------------------------------------------------------------------------------
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No. __--------------
To ------------------------------------------e'=e__Qrporatst --------------------------------
(Payee)
-------------------------------------------------------------------52~'YiA~ --~e"stTlI1S'IS~te~.S:I7~~t----------------------------
(Address) (City) (State)
No. and Date of
Date of Delivery
ARTICLES OR SERVICES
(Enter description item number of contract or Federal supply
QUANTITY
Q
UNIT PRICE
AMOUNT
Order
or Service
schedule, anal other information deemed necessary)
Discount Terms
7ny No.
Cost
Per
Dollars
Cte.
1.182 Supplemental
$,=
.0C
Release of Patent &
Royalties
PAYMENT:
Complete ^
Partial ^
Final ^
Use continuation sheet(s) if necessary
Shipped from to Weight Government B/L No.
Total
$5
. pC
(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 -------------------------------------------------------------------------
-------------------------- --------------------
---------- ? ------------------------------------
---------------
---------------
-----
-----
(This oertiftosto not regnirod who, a like oertiftoat, is made by payee on attached billor bills)
Amount verified; correct for -----------
Per ----------- ---------------------------- Title ----------------------------------------------
Contract No.+ _ Date Req. No.
Pursuant to authority vested in me, I certify that this account is correct and proper for paym
SIGN
ORIGINAL
ONLY
(iontracming oericer
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown; other classification optional)
C NO. -k-P, ~_
CNCZ
VF-EVIEWEfi:._ oi_^g
Check No. ________________________ dated ------------------------------ 19 ------ for $-------------------------------------- on Treasurer of the United States in
Paid by f { favor of payee named above.
Cash, $----------------------- on ------------------------------------, 19-----. Payee -------------------------------------------------------------------------
------- --- _--- (tia~r oriainai only)
FOIAb3b
* When a voucher is signed or receipted in the name of a company or cororation, the name of the crson
writing the com a ip~ o~y~y~1
- ----------------
John Doe Comp~ti Jbii~lhr8bdbtil~~d~SarA~ Sn6p ~p 1or 008T9RU0010D05QOII6-4
tIf the ability to certify and authority to approve are combined in one person, one signature only Is nec- Title ____________________________
essary; otherwise the approving officer will sign on the line below "Approved for $---------------------- and
over his official title. le--22905-)
Approved For Release 2000/04/19 : CIA-RDP81 B00879R000100050006-4
1. Advertising in newspapers Yes 1-1 No ^.
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 --------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
NoTx.-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 Rase 2000/04/19 : CIA-RDP81 B00879R000100050006-4
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