REQUEST FOR PAYMENT AND POSTING VOUCHER

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP90B00224R000300250007-8
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 3
• Document Creation Date: December 22, 2016
• Document Release Date: August 22, 2011
• Sequence Number: 7
• Publication Date: April 13, 1966
• Content Type: FORM

REQUEST FOR PAYMENT AND POSTING
VOUCHER
VOUCHER NO. -
TO : Accounts Division (Room Bldg. )
DIVISION VOUCHER NO.
THROUGH: Monetary Division (Room Bldg. )
?J
Request payment be made and/or transaction be recorded as indicated
below. Pertinent documentation in support of
this trans-
action is on file in this office.
SUBJECT
INVOICE NO(S).
/
PAYMENT TO
CONTRACT NO. u
,..
L~
U
11171,
JUNT
CHECK TO BE DATED
CASH PAYMENT I
U.S. TREASURY CHECK I
I
AGENT CASHIER CHECK
I
I BANK CASHIER'S CHECK
THE ATTACHED CHECKS AND/OR CASH IN THE AMOUNT OF $
SHOULD BE TAKEN INTO ACCOUNT AS INDICATED BELOW.
I HEREBY AUTHORIZE MY AGENT, WHOSE SIGNATURE APPEARS BELOW, TO RECEIVE S
OF OFFICIAL FUNDS IN CURRENCY ON MY BEHALF.
D/TE
SIGNATURE OF PAYEE I
DATE I
SIGNATURE OF AGENT
I
DATE
I SIGNATURE OF RECIPIENT
DESCRIPTION - ALL OTHER ACCOUNTS 13 - 33
54 - 89
STATION
40 -
41
42 - 47
OBLIG
48 - 49
50
CA
51 - 54
55 - 66
ALLOT. - COST - FAN
67 - 70
OBJECT
71 - 80
28 -88
T/A NO.
CODE
E
C
.
REF. NO.
PAY
OR
C
GENERAL
ACCOUNT SYMBOL
CLASS
AMOUNT
DESCRIPTION -
ADVANCE ACCOUNTS 18 - 27
-------
SNIP. DOC. NO.
REC. RPT. NO.
---------
p 0
ED
__
ADVANCE
ACCT. NO.
PER ER.
LI Q.
S
LEDGER
ACCT
NO
F II
IMF
61.- NO66
----------
1 68 - 70
DUE
DEBIT
CREDIT
-----------
B
B
-
E
MP
NO
CODE
T
.
.
S I
X REF
NO
DATE
DIV.
PROJECT NO.
DD
.
.
E
TR.
.
.
11
1
1 1;
3-
33o4l
51' ~? U
~~
^C .._
( V ?
~( ~
Jl ~',rl.i
r?
1
1
I
1
~1
-I 1
;-
1
1 1 1 1 1 1
1 ;
;;
I
1
1 I
1 1 1 1 1 ;
1 1 I I
1
f
t
I
1
I 1 1 I 1 1
t
I ~.
1
,
I 1 I
1
I1
1 I 1 1 11
I
I
1 1
1 1
1
1
I
1
; 1
1 1 I 1
1 I I 1 1 1 1 I
f
1 I I I 1 1
1-I
~
1
I 1 1 1 1 1
I
I
1
1 1 1 I I 1.
I
I 1 I 1 1 1 I 1 J I
I
I ~-1
F---1
_
1-I -
~
I
I
I 1 1 I
I
1 1 1 I 1
1 I I I 1 1 1 1 I 11
1
I
I
I
I
11 I I 11 t
1 1 1 I 1
I 1 I 1 11 1 I 1
-I.-
--1-
-I-
--1-1-4-F--1-1-
-1-
---
-
1
1
1
1
1
1
I
I
1
I 1 1 1 1 1 I 1;
1 1
1 I
I
0 1
1 I 1 11 I I;
1
I I
I 11~'
()
1 I I
I
I
~ I
DATE DATE REVIEWED BY
CERTIFIED FOR PAYMENT OR CREDIT
25X1
DATE SIGNATURE OF CERTIFYING OFFICER
FORM 1822 OBSOLETE
$_ga
SECRE
GROUP 1
EXCLUDED FROM AUTOMATIC
(10-49)
DOWUSNADINS AND DECLASRIFICATION
Sanitized Copy Approved for Release 2011/08/22 : CIA-RDP90B00224R000300250007-8
SECRET
(When Filled In)
Sanitized Copy Approved for Release 2011/08/22 : CIA-RDP90B00224R000300250007-8
 Sanitized Copy Approved for Release 2011/08/22 : CIA-RDP90B00224R000300250007-8
Standard Form No. 1084 PUBLIC 'OCHER FOR PURCHASES AND
7 GAO 5000
1094-110-04 SERVICES OTHER THAN PERSONAL
U.S. DEPARTMENT, BUREAU, OR ESTABLISHMENT AND LOCATION
DATE VOUCHER PREPARED
VOUCHER NUMBER
31 March 1966
7
CONTRACT NUMBER AND DATE
PAID BY
REQUISITION NUMBER AND DATE
r 1
I
25X1
PAYEE'S
NAME
DATE INVOICE RECEIVED
AND
___
ADDRESS VVV
DISCOUNT TERMS
L J
PAYEE'S ACCOUNT NUMBER
SHIPPED FROM TO WEIGHT
GOVERNMENT B/L NUMBER
NUMBER
DATE OF
ARTICLES OR SERVICES
QUAN-
UNIT PRICE
AMOUNT
AND DATE
OF ORDER
DELIVERY
OR SERVICE
(Pbsar description, item number of contract or Pederal
.apply schedule. and other informaian deemed n.ceasmy)
TITY
COST
p
('I
19 Feb
Reimbursable Costs
8247.54
25 Mar
Fixed Fee
784.17
25X1
Dat
!APR
lJ I9FF
Irate}
ssar
) if
h
(
)
TOTAL
9031.71
(Use continuation s
y
nece
s
es
PAYMENT:
APPROVED F
OR
D
IFFERENCES
R COMPLETE
_ $
=$1.00
PARTIAL BY
FINAL
^ PROGRESS TITLE
Amount verified; correct for
13 ADVANCE
(9lp atera or uuials)
Pursuant to authority vested in me, I certify that this voucher is correct and proper for payment.
(Date) (Authorized Certifying Officer)' (le)
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown; other classification optional)
Appropriation Symbol
and Subhead
Object
Class
Expenditure
Account
Chargeable
Activity
Bureau Cont. or
Subauth'n Activity
Bureau
Control No.
Sub-
auth'n No.
Identifi-
cation No.
Amount
I.R. No's.
CHECK NUMBER ON TREASURER OF THE UNITED STATES
CHECK NUMBER ON (Name of bank)
Q
CASH DATE
PAYEE '
IL
$
1 When stated in foreign currency, insert name of currency.
Y If the ability to certify and authority to approve are combined in one person, one signature only is necessary;
ial title
ffi
hi
PER
.
s o
c
otherwise the approving officer will sign in the space provided, over
When a voucher is receipted in the name of a company or corporation, the name of the person writing the
"
TITLE
John Doe
company or corporate name, as well as the capacity in which he signs, must appear. For example:
-upany, per John Smith, Secretary" or "Treasurer", as the case may be.
Sanitized Copy Approved for Release 2011/08/22 : CIA-RDP90B00224R000300250007-8
 Sanitized Copy Approved for Release 2011/08/22 : CIA-RDP90B00224R000300250007-8
6624.00
TOTAL 76289.00
ANALYSIS OF CLAIM,IE:'D CURRENT AND
CUMULATIVE COSTS AND FE_ EARNED
MAR 25,1966
CLASSIFICATION OF COSTS
SALARIES AND WAGES
TECHNICAL OVEREAD ( .846000)
MATERIALS AND SERVICES
TRAVEL
SUBCONTRACTS
TOTAL DIRECT COSTS
GENERAL/ADMIN. CCSTS ( .186300)
TOTAL COSTS
FIXED FE_ EARNED (PCT COv=.)
TOTAL AMOUNTS CLAIMED
Materials and Services:
Computer usage
Services of D. Stone, 9-28 Feb.,
96 hours
PC 'ic Voucher for Purchases anc'
oervices Other Than' Personal
CONTINUATION SHEET
Sheet No. 1 of Bureau Voucher No. 7
CURREN! T "10
2936.94
2484.66
1532.43
0.00
0.00
6954.36
1293.46
8247.54
784.17
9031.71
$3.48
1529.00
1532.48
FISCAL YR/DT
7233.34
6119.41
2429.81
0.00
0.00
15732.55
2935.:6
16718.12
2155.66
20873.78
PER IcD/DATE
17359.90
14694.94
2337.06
43.95
0.00
34945, G
64y9.~q
41=+4;.7d
^P40.66
45385,4+
Sanitized Copy Approved for Release 2011/08/22 : CIA-RDP90B00224R000300250007-8