REQUEST FOR PAYMENT AND POSTING VOUCHER
Document Type:
Collection:
Document Number (FOIA) /ESDN (CREST):
CIA-RDP90B00224R000300250010-4
Release Decision:
RIPPUB
Original Classification:
S
Document Page Count:
3
Document Creation Date:
December 22, 2016
Document Release Date:
August 22, 2011
Sequence Number:
10
Case Number:
Publication Date:
March 1, 1966
Content Type:
FORM
File:
Attachment | Size |
---|---|
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Body:
Sanitized Copy Approved for Release 2011/08/22 : CIA-RDP90B00224R000300250010-4
(When Filled I
REQUEST FOR PAYMENT AND POSTING VOUCHER
Accounts Division (Room Bldg. )
p n (Room Bldg.
1o
Monetary v1s
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.
U I I
~( U.S. TREASURY CHECK AGENT CASHIER CHECK
CASH PAYMENT f\
SHOULD BE TAKEN INTO ACCOUNT AS INDICATED BELOW.
THE ATTACHED CHECKS AND/OR CASH IN THE AMOUNT OF S
OF OFFICIAL FUNDS IN CURRENCY ON MY BEHALF.
I DATE I SIGNATURE OF RECIPIENT
1 HEREBY AUTHORIZE MY AGENT WHOSE SIGNATURE ADPPEE RS BELOW. S TO RECEIVE S GNATU E OF AGENT
SIGNATURE OF PAYEE I I
BJECT AMOUNT
DESCRIPTION - ALL OTHER ACCOUNTS 40- 42 - 47 48.49 50 CA 51 - 54 ALLOT. - 55-66 COST -FAN O67 -70 71-80
13 - SS 84 ' S9 41 OBLIG. ACCOUNT SYMBOL CLASS
28 - S8 S CODEN E REF. NO. --- PAY OR GENERAL 1 F 61-66
168 - 70
C 1
C
NO. _ X
DEB 1 T
ADVANCE PER. 0 LEDGER F J u l CK. NO. _
P O _ LIC. S --_____-.
- --_ - ACCT. NO- I DOE
SHIP. DOC. NO. REC. RPT. NO. E O ACCT. NO. i DATE
DESCRIPTION
ADVANCE ACCOUNTS 13 .27 -- ~82=gg eenmrr MO. M E ENP. NO. CODE TR. Y N ]I REF. NO.
CERTIFIED FOR PAYMENT OR CREDIT
GROUP I
EXCLUDED FROM AUTOMATIC
DOWNGRADING AND DRCLARRIFICATION
25X1
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Sanitized Copy Approved for Release 2011/08/22 : CIA-RDP90B00224R000300250010-4
standard Form No. 1084 PUBLIC OUCHER FOR !!URA'" -?4D
7 GAO 5W 108411044 SERVICES OTHER THAN-_, -I'1AL
U.S. DEPARTMENT. EAU. ESTABLISHMENT AND LOCATION
DATE VOUCHER PREPARED
VOUCHER NUMBER
6
28 February 1966
CONTRACT NUMBER AND DATE
PAID BY
REQUISI'1fON NUMBER AND DATE
F
2
5
PAYEE'S
NAME
DATE INVOICE RECEIVED
AND
ADDRESS
DISCOUNT TERMS
L -~
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
(Sbkr descripe1ea. item quasber of ooab' er hdsr&
aid other h0madon deassed nowssar7)
h
d
i
b
TITY
COST
PER
I'1
OF ORDER
OR SERVICE
sa
s
a
t,
ssq,p
22 Jan -
Reimbursable Costs
4971.79
18 Feb
Fixede
1371.49
1966
1 P
son. s, 1
01
25X
MAR
196
(Date)
28
TOTAL
(Use continuation s
he&Ks) if necessary
)
PAYMENT: APPROVED FOR
EXCHANGE RA
DIFFERENCES
COMPLETE _ $
_ $1.00
PARTIAL BY r
HNAL
PROGRESS TITLE
Amount vearllled; correct for
ADVANCE
(Slaudwv or bs fiats)
Pursuant to authority vested in me, I certify that this voucher is correct and proper for payment.
(path) (Ardtorized Certifying Officer) I f"Ttle)
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-
euth'n No.
Identifi-
cation No.
Amount
I.R. No's.
CHECK NUMBER ON TREASURER OF THE UNITED STATES
CHECK NUMBER ON (Name of bank)
CASH DATE
PAYEE'
$
1 When stated in foreign currency, insert name of currency.
I If the ability to certify and authority to approve are combined in one person, one signature only is necessary;
his official title
d
id
PER
.
, over
e
otherwise the approving officer will sign in the space prov
I 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:
Company, Per John Smith, Secretary" or "Treasurer", as the case may be.
Sanitized Copy Approved for Release 2011/08/22 : CIA-RDP90B00224R000300250010-4
ESTIMATED COSTS S 69665.00
FIXED FEE 6624.00
TOTAL 76289.00
85PCT OF FIXED FEE 5630.40
ANALYSIS OF CLAIMED CURRENT AND
CUMULATIVE COSTS AND FEE EARNED
FEB 18,1966
CLASSIFICATION OF COSTS
SALARIES AND WAGES
TECHNICAL OVERHEAD ( .846000)
MATERIALS AND SERVICES
TRAVEL
SUBCONTRACTS
TOTAL DIRECT COSTS
GENERAL/ADMIN. COSTS ( ?186000)
TOTAL COSTS
FIXED FEE EARNED (PCT COMP)
TOTAL AMOUNTS CLAIMED
I _e'P 1",11v,(/.,! \ ,
Materials and Services:
Computer usage charges
Telephone charges
D. Stone, services , 1-8 Feb.,
50.75 hours
CURRENT MO FISCAL YR/DT PERIOD/DATE
1805.73 4296.40 14432.96
1527.64 3634.75 12210.28
858.69 897.33 1304.58
0.00 0.00 43.95
0.00 0.00 0.00
4192.06 8828.48 27991.77
779.73 1642.10 5206.47
4971.79 10470.58 33198.24
1371.49 1371.49 3156.49
6343.28 11842.07 -d 36354.73
/G.~ ~
1--/. -z v
$ 43.05
9.99
805.65
$858.69
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PLC' 'ic Voucher for Purchases and
.jervices Other" T~ ,n Personal
CONTINUATION SHEET
Sheet No. 1 of Bureau Voucher No. 6
Sanitized Copy Approved for Release 2011/08/22 : CIA-RDP90B00224R000300250010-4