ACCOUNTING BY INDIVIDUAL FOR ADVANCE

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP78-04901A000100020166-3
• Release Decision: RIPPUB
• Original Classification: C
• Document Page Count: 2
• Document Creation Date: December 12, 2016
• Document Release Date: June 26, 2001
• Sequence Number: 166
• Publication Date: July 1, 1949
• Content Type: FORM

>f'A l.'i~tC A# _ EXHIBIT "C"
Approved For Relea 2001/08/0 00100020166-3
ING BY INDIVIDUAL FOR ADVNCE
SPECIAL FUNDS
NOTE: SEE INSTRUCTIONS ON REVERSE SIDE.
TO: Ii IV" p s 0+>i s
or"Oh.
DATE
I Jul 1'"s
FROM:
ftemrd Roo,
SUBJECT:
Accounting for the period from 1 AM 1 to i! 1$4 inclusive.
1. CASH ON HAND $ ."~
( to of osa o 1 st ccoun t g o
)a. dva.vces ov -s1&.4 . s o f i !iy,p i dl IVa hl',E
2. RECEIPTS DURING ACCOUNTING PBIOD:
DATE RECEIPT NO. DESCRIPTION
~r
S
NF c$ k* I Moss to !:, ft* $ 3.,~'.O1
TOTAL TO BE ACCOUNTED FOR $ ,'.
3. EXPENDITURES DURING ACCOUNTING PERIOD:-
DATE VOUCHER NO. DESCRIPTION
*W OtUwhod h 4q o I> "`11 '
s
$
oft"bod o go* I a FFr ?1u. 33-11
4. RETURNED HEREWITH: $,
(Describe - Cash, Check, Money Order, Etc.)
5. CASH ON HAND $
(Date of closing of this accounting period
INCLUDES CASH ON HAND OR OTHERWISE IN POSSESSION. J
TOTAL ACCOUNTED FOR $*
.
IF OTHER THAN ACTUAL CASH ON HAND. DESCRIBE FULLY.
6. I CERTIFY that the expenditures itemized on this accounting 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, re-
imbursed therefor from any source, Government or private; and that this voucher and attachments, if any, are true
and correct in all respects.
SIGNATURE
7. APPROVED:
DATE TITLE SIGNATURE
r3. I CERTIFY that this accounting has been examined by me; that receipts or other substantiating data have been
furnished me, or a satisfactory explanation made for the failure to furnish same; that it appears from such data
that the itemized expenditures were for necessary official purposes, reimbursement for which is allowable under
existing regulations; and that such expenditures are properly chargeable to the accounts indicated below.
DATE p lAtR """ 20, 1 4 FYING OFFICER
FORM NO. as.16
 Approved For Releao
I c. 11
10002tT"f`66='
INSTRUCTIONS
1. If funds ina form other than U.S. Dollars were on hand, received or disbursed during account-
ing period, all pertinent data, i.e. rate, method of acquisition, et'c. must be shown.
2. If more space is required to explain receipts, prepare receipt form, number and attach hereto.
In every case, completely identify the source of receipts.
3. Obtain and number each voucher for expenditures (such voucher can be the receipt obtained from
payee). Where no receipt is obtained, prepare certificate in accordance with SF Regulations,
number in sequence with vouchers, and attach hereto, along with all other vouchers. If more
space is required to list or explain expenditures, enter in total on this form and attach item-
ized schedule.
Final credit will not be given for disbursements which are advances to be accounted for. Such
disbursements must however be listed as expenditures in order to balance the Cash Report. In
case of such advances, attach a statement or memo to this accounting, listing all advances out-
standing for which you are responsible and for which you will obtain an accounting. When such
accountings are obtained, attach to your next report and itemize by covering memorandum.
Approved For Release 2001/08M IlA000100020166-3