REQUEST FOR PAYMENT AND POSTING VOUCHER
Document Type:
Collection:
Document Number (FOIA) /ESDN (CREST):
CIA-RDP90B00224R000300250003-2
Release Decision:
RIPPUB
Original Classification:
S
Document Page Count:
3
Document Creation Date:
December 22, 2016
Document Release Date:
August 22, 2011
Sequence Number:
3
Case Number:
Publication Date:
September 23, 1966
Content Type:
FORM
File:
Attachment | Size |
---|---|
![]() | 148.88 KB |
Body:
Sanitized Copy Approved for Release 2011/08/22 : CIA-RDP90B00224R000300250003-2
REQUEST FOR PAYMENT
AND POSTING VOUCHER
VOUCHER NO. -
TO t Accounts Division (Room
Bldg.
)
DIVISION OUCHER NO.
-
THROUGH: Monetary Division (Room
Bldg.
)
s
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.
INVOICE NO(S). /0
SUBJECT
PAYMENT TO
CONTRACT NO.
CHECK TO BE DATED
_.4OUNT
i
O
~ -7 62 3
CASH PAYMENT 1
41 U.S. TREASURY CHECK
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 $
OF OFFICIAL FUNDS IN CURRENCY ON MY BEHALF.
DATE
SIGNATURE OF PAYEE
DATE
SIGNATUR
E OF AGENT
DATE
SIGNATURE OF RECIPIENT
DESCRIPTION - ALL OTHER ACCOUNTS 13 - 33
34.39
TATION
40.
41
42 - 47
OBLIG
48 - 49
SO
CA
51 - 54
A
55 - 66
LLOT.. COST - FAN
67 - 70
OBJECT
71 - 80
-33
2/8
S
CODE
E
.
REF. NO.
PAY
OR
GENERAL
ACCOUNT SYMBOL
CLASS
AMOUNT
DESCRIPTION
ADVANCE ACCOUNTS 13-27
T
A
fNI P. DOC. NO.
------- .__.
REC. NPT. NO.
__________
x o
E D
N
ADVANCE
ACCT. NO NO_
________ -
PER.
LIQ.
CODE
o
S
T
LEDGER
ACCT. NO.
F!
F U
IDI
Y
61 66
CK. NO.
168-70
DUE
BRUIT
CRED
IT
12.39
3
DIY.
PROJECT NO.
E
EMP. NO.
YR.
I
S
X REF. NO.
DATE
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TOTALS
DATE DATE
REVIEWED BY
CERTIFI D FOR PAYMENT OR CREDIT
DA S E P SIGNA OF CERTIFYING
1966 (Sig_ned )
2
[ 10.41)
iF
F2 66 1822 OBOLITC PI EVIOU9 EDITIONS SECRE, hem YRR
AtliO~ATIC
Sanitized Copy Approved for Release 2011/08/22 : CIA-RDP90B00224R000300250003-2
sECRKT
(When Filled In)
5X1
Sanitized Copy Approved for Release 2011/08/22 : CIA-RDP90B00224R000300250003-2
Atanaara t' orm i' O. tu34 PUBLIC VOUCHER FOR
PURCHASES AND
7 GAO 50"
SERVICES OTHER THAN PERSONAL
1081-110.04
U.S. DEPARTMENT, BUREAU, OR ESTABLISHMENT AND LOCATION
DATE VOUCHER PREPARED
VOUCHER NUMBER
30 Tune 1966
10
CONTRACT NUMBER AND DATE
PAID BY
REQUISITION NUMBER AND DATE
4`a
25X1
PAYEE'S
NAME
?."
DATE INVOICE RECEIVED
AND
ADDRESS
DISCOUNT TERMS
PAYEE'S ACCOUNT NUMBER
SHIPPED FROM TO WEIGHT
GOVERNMENT B/L NUMBER
NUMBER
DATE OF
ARTICLES OR SERVICES
QUAN-
UNIT PRICE
AMOUNT
AND DATE
DELIVERY
(Enter description, item number of contract or Federal
TITY
OF ORDER
OR SERVICE
supply schedule. and other information deemed necessary)
COST
PER
21 May
Reimbursable Costs
7023.10
24 June
Fixed Fee
-0-
25
X1
(Date),
23s; 6
(Date,,
(Use continuation sh
eet(s) if necessary)
Payee mus NUI use the space below)
TOTAL
7023. 10
PAYMENT:
APPROVED FOR
EXCHANGE RATE
DIFFERENCES
p COMPLETE
$
_ $1.00
E PARTIAL
BY'
[] FINAL
F] PROGRESS
TITLE
Amount verified; correct for
^ ADVANCE
(Signature or initials)
Pursuant to authority vested in me, I certify that this voucher is correct and proper for payment.
(Date) (Authorized Certifying Officer' (Title)
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown; other classification optional)
Appropriation Symbol
Object
Expenditure
Chargeable
Bureau Cont. or
Bureau
Sub-
Identifi-
Amount
and Subhead
Class
Account
Activity
Subauth'n Activity
Control No.
auth'n No.
cation No.
I.R. Not,
CHECK NUMBER ON TREASURER OF THE UNITED STATES
CHECK NUMBER ON (Name of bank)
0
Q
CASH DATE
PAYEE'
6
' When stated in foreign currency, insert name of currency.
PER
a If the ability to certify and authority to approve are combined in one person, one signature only is necessary; otherwise the approving
officer will sign in the space provided, over his official title.
s When a voucher is receipted in the name of a company or corporation, the name of the person writing the company or corporate
"
TITLE
or
name, as well as the capacity in which he signs, must appear. For example; "John Doe Company, per John Smith, Secretary
"Treasurer", as the case may be.
Sanitized Copy Approved for Release 2011/08/22 : CIA-RDP90B00224R000300250003-2
a
0
CONTRACT NO. 25X1
{
ESTIs'IATEU COSTS 74037.00
FIXED FEE 7061.00
TOTAL ,81098.00
0
0
Sanitized Copy Approved for Release 2011/08/22 : CIA-RDP90B00224R000300250003-2
Pubi` VGUL'i rc , ~~u~cnas~ s ar d
Services Other Than Personal
0
U.S. Sheet No. 1 of Bureau Voucher No. 10
85PCT OF FIXED FEE 6001.85
ANALYSIS OF CLAIMED CURRENT AND
CUMULATIVE COSTS AND FEE EARNED
24 JUNE 1966
CLASSIFICATION OF COSTS
? SALARIES ANU 44A(3ES
TECHNICAL OVERHEAD ( .846000)'
MATERIALS AND SERVICES
TRAVEL
SUBCONTRACTS
TOTAL DIRECT COSTS
? GENERAL/ADMIN. COST? ( .186000)
TOTAL COSTS
EXCESS COSTS
? TOTAL ALLOWABLE COSTS
FIXED 'FEE EARNED (PCT COMP.)
TOTAL AMOUNTS CLAIMED
0
CURRENT MO FISCAL YR/DT PERIOD/DATE
4623.41 20420.1:8 30557.24
3911.41 17275.90 .25851.43
2727.50. 10906.58 11313.83
0 0 43.95
0 0 0
11262.32 48603.16 67766.45
2094.79 9040.19 12604.56
13357.11 57643.35 80371.01
-6334.01 -6334.01 -6334.01
7023.10 51309.34 74037.00
0 4216.85 6001.85
7023 10 55526.19 80038.85
0 Materials and Services:
0
0
0
0
0
0
0
0
Stone Services 1-31 May 2628.34
Williams Phone Charges 10 June 10.67
Computer Usage 88.49
0
0
0
0
Sanitized Copy Approved for Release 2011/08/22 : CIA-RDP90B00224R000300250003-2