MKULTRA SUBPROJECT 148 (13 DOCUMENTS WITH PUBDATES FROM 631024 TO 6411 09)

Document Type: 
Collection: 
Document Number (FOIA) /ESDN (CREST): 
00017408
Release Decision: 
RIPPUB
Original Classification: 
U
Document Page Count: 
48
Document Creation Date: 
August 23, 2024
Document Release Date: 
September 8, 1976
Sequence Number: 
Case Number: 
Publication Date: 
October 24, 1963
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PDF icon MKULTRA SUBPROJECT 148 [8144520].pdf3.04 MB
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..�: 1.11 3 -24 Oct. '63 1 year ::(3�171.-; 1 ":1 1:.01; r Pete Authorization #1 24_0ct Invoice .# 1 _ 27, . Nov. - -7�1": -4 4(.714)..t..., '- 1412 5- 13 9 0 -390 5,000.00 (rt 1 Ot.11�il 114 CT.!. - 5-000.00 5 000 00 500.00 4,500,00._ 4'7; 07,4c � 670-0 00 / (,) Receipt is hereby acknowledged of Tre urer's Check No. L101412, dated October 30th, 1964, drawn on the payable to D $500.00. in the amount of C DATE Are,/ if 6" ei," 15 Ckaober 1964 116 cf) /Pi 17 $500.00 CONEAPLTANT rRMACOLOGY AND 1ICC'LO&1V ;. For consultation and special services rendered, May and June 1964 I certify that services or Taterials have beerk�_ satisfactorily received ,71 were incurred on o "I":111014.' (Whenn) REII�.2URSEt�:ENT VOUCHER FOR PURCHASES AND t � . SERVICES OTHER THAN PERSONAL INKULTZA Subproject #143 NAME 01= CLAIMANT 1 VOUCHER NO. (Finance Uric Only) DESCRIPTION OF S PENDiTURE ATTACH RECEIPTS AND OTHER SUPPORTING DOCUMENTS 1 Paymc t to Dr. or Invoice Xo. .9, professional services rendered 1,500.00 MI:UL=A Subprojec ), eara. 1V-D of NKJLTnA Fiscal Annex. 1 certify that, , to the best of my knowledge and belief, the amount shown has been disbursed for 1 Agency-authorized activities and services or materials have been received. The document upon which this statement is based is maintained in the files of TSD for security reasons/and will be made auailable to the certifying officer at his request. I , . c.) , Please forward check ..t .hrou.!6 " - �.....,� ,.... ,. LRTIFY THAT THE DISBURSEMENTS ITEMIZED ABOVE WERE. NECESSARILY MADE BY OF OFF IC I AL BUS INESS OF A CONE !DE NT I Al. EXTRAORD !NARY, OR EMERGENCY NATURE ME IN THE. CONDUCT . THAT I I HAVE NOT4 z.,,,,titorize my oitene, whose signature appeersbelow, to receiv g:54,=== receipt orsoch nil '''eY 'thereto,' when paid to an' agent' . BEEN, NOR WILL I BE, REINZWRSED THEREFORrFROM ANY OTHER SOURCE, AND THAT TACHmENTS ARE TRUE AND CORRECT, 1 S OCT Tasl THIS CLAIM AND. A .. DATE :SIGNATuRE OF PAYEE r 13 Oct 64 . SIGNATURE OF �! DATE ISIGNATORE OF AGENT I CERTIFY FUNDS ARE AVAILABLE I APPROVED i OBLIGATION REFERENCE NO. CHARGE COST ACCT. NO. , DATE iSIGNATURE OF APPROVING OFFICER � RECEIPT FOR FUNDS RECEIVED 219 4125-1390-3901 ISIDNMY GOTTLIEB,DC/TSD PAYMENT RECEIVED DATE AUTHORIZED SIGNATURE CERTIFIED FOR PAYMENT OR CREDIT IN THE AMOUNT OF 3 DATE 11SIGNATURE OF CERTIFYING OFFICER , 1 h DATE SIGNATURE OF 0 PAYEE 0 AGENT SPACE BELOW FOR EXCLUSIVE USE OF CONFIDENTIAL'FUNDS DIVISION PREPARED BY REVIEWED BY VOUCHER NO. 7.12 -.5CR1 TioN.ALL OTHER ACCOUNTS 13-33 34-39 40.42 43 451.46 p'1,,,y PER.. L',w,, � 47.52 OBLiG. REF. No. 53 54-57 GENERAL 1 58.67 l6.9.70 ALLOT. OR COST ' DUE , ACCT. NO. 1DATE 71.80 AmOUNT , DESCRIPTION-ADVANCE ACCOUNTS 12.27 28.33 - T/4 No. RUR.ORDERNO. STATION CODE RPOP. NO. '' �...... PROJECT NO. ,,,,,NDFuNDS CODE ry DEBIT CREDIT - - r. WDEA.NCE ACCOUNT NO. EMI,. NO, LEDGER ACCOUNT NO, . 52� 57 il OR. CR. LI NO Ec, x F. 64. iLLAse 1:11, fen. ' zN THr-- is.!." NT CF. . � . . . . Ill .70 r.. (, I I - 1 1 1 TOTALS F3?:7 264. PREV6OCS BECEIFT ipt is hereby acknowle ged or Treasurer's Check 18 atedi ust PaY- 000,00. MARE: DATE: I 4. 96)4 For services rendered, June 1964 a camoifiat s'erviosesm' havo boon battraiOttly ftctivedtrexpnatum or InQiirleed On 0 CONSULTANT P3HARMACOLOGY AND TOXICOLOGY � 11 July 1.964 $500.00 CONt4ULTANT PAIAFetsie9COLOCAY ANT') TOKICOLOGY 11 July 1964 Gentlemen: Gurrent_work_in this laboratou by Dr ni associates. The effects of a synthetic dimethyl heptyl analogue active ingredient of marihuana are being compared with those of thiopental on EEG arousal in acute' cat preparatiGns, EEG and behavioral arousal in chronic cat preparations, and on the transfer of sensory impulses through the brain stem reticular formation. This work is aimed at elucidating the mechanism of the CNS depression caused by the marihuana analogue. Yours v r truly, - (when jiJled in) r�IIII1101.111~/1.0/1~mINIIMINE.ft NAME OF CLAIMANT REWBURSEMENT VOUCHER FOR PURCHASES AND 144=7.7,,TRA ub l'-,148 'VOUCHER NO. (FinBnce u e only) SERVICES OTHER 'THAN PERSONAL CHARGE TO ALLOTMENT OR PROJECT 4 / r: / 9 0REIU wt BURSEi4ENT OR PAYMENT IS CLAIMED FOR MATERIALS, SERVICES, OR OTHER EXPENDITURES ITEMIZED BELOW WHICH ARE PROPERLY CHARGEABLE TO THE ALLOTMENT OR PROJECT DESIGNATED. DESCRIPTW EXPENDbTURE - AT AOH RECEIPTS AND OTHER SUPPORTING DOCUMENTS AMOUNT Payment to Dr. . r Invoice No. 3, professional services rendered MICULT Subproject No. 143, pe para. oi ...t...VULTRA Fiscal Annex. ',I certify that to the best of my knowledge and belief, the amount shown has been disbursed for Agency-authorized activities and services cr materials have been received. The document upon which this statement is based is maintained in the files of TSD for security reasons and Will be made 'available to the certifying officer at his request. I ' Please forward cheek to hroug 1 $500.00 I CERTIFY THAT THIS VOUCHER AND ANY ATTACHMENTS ARE COR3ECT.,THE EXPENDITURES WERE INCURRED ON OFFICIAL BUSINESS OF A CONFIDENTIAL. EXTRAORDINARY. OR 1 EMERGENCY NATURE: PAYMENT OR CREDIT HAS NOT BEEN RECEIVED. AND t SHALL,NOT BE REIMBURSED FROM ANY OTHER SOURCE. ' I CERTIFY FUNDS ARE AVAILABLE APPROVED DATE, SIGNATURE OF PAYEE.. OBLIGATION REFERENCE NO.CHARDE,ALLOTMENT NO. DATE 1 SIGNATURE Of APPROVING OFFICER , 1 ca i 1 31' Jul 6 z _ 1 .512..;'� .TU1 19641 lai7f CIOTTL:IEB,?Ci PAYMENT RECEIVED . DATE 1SIIAJRE OF AUTHORIZ NG OFFICER CERTIFIED FOR PAYMENT OR CREDIT '1 IN THE AMOUNT OF $ 4. AUG 1954 , DATE SIGNATURE OF CERTIFYING OFFICER DATE. SIGNATURE OF RECIPIENT SPACE BELOW FOR EXCLUSIVE USE OF FINANCE DIVISION PREPARED BY w REVIEWED BY 1VOUCHER NO. 7-1 ' rDESCRIP ION-ALL OTHER ACCOUNTS t -33 34.39 40.42 43 45-461 47.52 , 53 5,4-57 58-67 , 8-70 71-80 6 23 DESCRIPTION-ADVANCE ACCOUNTS --.-----... STATION CODE EXPEND-- ****COOE I r,, c is.... L '�' PER. 08LIG REF. Md. I - - CA GENERAL l' ALLOT. OR COST ACCT. 80. DUE DATE. AMOUNT ,....� 13-2/ . O.UR.ORDERNO. RAOP, NO. ' I LIO. c7ge' io7,,re' ACCOUNT MO YR LEDGER H2-67 ..0. OR ilVACCOUNT IRROJECTRIO.. 'Y "" ICIAP. NO. NO. CREDIT, . 8 0 � 0 0 � . ** .. .. TOTALS L.............................. jORM USA R�VTIC,t 6-SO tOtTif�nt RECEIPTS Receipt is hereby acknowledged of Treasur Cheeks Nos. L101291 ancY1,101292,_dated 10 June 1964, drawn on._ NAME DATE 4111�1111111 (When Filled In) ,.................... I NAME OF CLAIMANT REIMBURSEMENT VOUCHER FOR PURCHASES AND '.':.7.727_,=, 211zt--,,t VOUCHER NO. (Finance use only) SERVICES OTHER *THAN PERSONAL ICHARGE TO ALLOTMENT OR PROJECT ----..; PE:mBGRsempNT OR PAYMENT IS CLAIMED FOR MATERIALS, SERVICES, OR OTHER EXPENDITURES ITEMIZED BELOW WHICH ARE PROPERLY CHARGEABLE TO THE ALLOTMENT OR PROJECT DESIGNATED. . DESCRIPTION OF EXPENDITURE - ATTACH RECEIPTS AND OTHER SUPPORTING 00CUMENTS AMOUNT , 17'n:7: o- t to - or Invcice No.. 7, for professiona/ services rendered �""/"*. �-,", A 4.3., ,'�-, '`' ....� , L., ;. 24 1.1 . 4 V - ar i of i'.''.1 U:1E:: A :Fiscal Amnex. Z certify that � to the test 1.: ::",:.,.. 014_t!t E:..10.7,7 ,7rAZ2 tCCn, ,f;Tisbursed g,!::,r A:.&eney-Allt:!lerized neti - .'tler.,�,. rz-Jd� services cr v:aterials have Leon received. Ilie eccuser.t.v.111011 VA:11C-ii thiS t,0C:,:t. 71s ,:td ...ks Taintain. in to files off. TrZi or security reasomr., an.d vill. be r,:t (""4.�':aila1.71.0 to te (.crtifyir.47, officer at his ,72"..eoso 1�0171%1 ehec:. to !,"21'. later!! th ''.0 100.A. 'tt..) I I CERTIFY THAT THIS VOUCHER AND ANY ATTACHMENTS ARE c4pi EMERGENCY NATURE, PAYMENT OR CREDIT HAS NOT BEEN Rgciv CT. THE EXPENDITURES WERE INCURRED ON OFFICIAL BUSINESS OF A CONFIDENTIAL. EXTRAORDINARY. OR 0, AND I SHALL NOT BE REIMBURSED FROM ANY OTHER SOURCE. I CERTIFY FUNDS ARE AVAILABLE : I APPROVED DATE , SIGNATURE Or PAYEE OBLIGATION ,REFERENCE NO. CHARGE ALLOTMENT NO. 41:':5-32:7X-sDon DATE SIGNATURE OF APPROVING OFFICER 1 C4 CERTIFIED .7.::::rnly f.:?';t1'2I.,17..7.1,�ThCiTED FOR PAYMENT OR CREDIT PAYMENT RECE I VED IN THE AMOUNT OF $ DATE SIGNATURE OF AUTHORIZING OFFICER I- 9 , SS4 '04TE I 14 SIGNATURE Or CERTIFYING OFFICER DATE , TSIGNATURE OF RECIPIENT SPACE BELOW FOR EXCLUSIVE USE OF FINANCE DIVISION PREPARED BY REVIEWED BY i I1 VOUCI4ER NO. 7.12 't ,CRIPTION -ALL OTHER ACCOUNTS 13.33 34-35 L 10-42 43 45H46-' 47'55 5 : 54-57 58-87 68-70 DUE 71-80 ,....H, 2_ .33 OESCPIPTION.ADVANCE !I- 7'4* STA,TaN AFIel.NG � C''""'' FUNDS ' PAY PER. ! ap!.-1& ,CA aFNFRAL ALLOT OR COST ACdT . NO. 1 'DATE AMOUNT I ACCOUNTS 13-27 IPUR.ORDERNO. PROP. NO. CODE LfO. - ADvArce ACCOuNTNC YR LE0G,R $ P2.... ;2::,. .3i. , PROJECT NO. . FT CODE emp, .0, ACCOUNT NO. Ref. NO. CLASS SE BIT CREDIT .... '. .. . .. ' . .... . ..... ..... .. . .. L . .... � ...... 1 1 TOTALS FM 264 vt, ATI stt.s. v t T.,4111 For services rendroed, May 1964 I certify that sarvieeS oi LaW satisfactorily received inl tho expendttured-- -- were incurred on.' fiat:0A fitILTANY 'Y ANT) TOXic01- .y1964 When NAME OF CLAIMANT REIMBURSEMENT VOUCHER FOR PURCHASES AND 2:17,45L1$1A. &thproject #148 VOUCHER NO. (Finance owe only) � SERMES OTHER THAN PERSONAL CHARGE TO ALLOTMENT OR PROJECT .. 41 `>5.-.1 2 .50-24)02 ____ REIME..:RGEMENT OR PAYMENT IS CLAIMED FOR MATERIALS. SERVICES. OR OTHER EXPENDITURES ITEMIZED BELOW WHICH ARE PROPERLY CHARGEABLE TO THE ALLOTMENT OR PROJECT DESIGNATED. . DESCRIPTIO OK EXPENDITURE � ATTA:CH RECEIPTS AND OTHER SUPPORTING DOCUMENTS --.. _. AMOUNT .; - � -, P;177"T'NT TO Dr. or Invoice or professional services sut:project 143, J r'l 1V-D of the =ULTRA Viscal Annex. I certify of my hnoyledge and belief the amount shown has been disbursed for Agency activities, and services or materials have been received. The documents this statement is-based are-maintained.in the files of TED for security will be made available to the certifying officer at his request. �,..,...., . ,_)lease fo,0,rd check no later than 15 Eay 1964. . rendered mrcy.TnA that to the best -authorized upon which reasons -and 1 $500.00 ' I CERTIFY THAT THIS VOUCHER AND ANY ATTACHMENTS ARE CORRECT. THE EXPENDITURES WERE INCURRED ON OFFICIAL BUSINESS' Of A CONFIDE 'NAL, EXTRAORDINARY. DR EMERGENCY NATURE: PAYMENT OR CREDIT HAS NOT BEEN RECEIVED, AND I SHALL NOT BE REIMBURSED FROM ANY OTHER SOURCE I CERTIFY FUNDS ARE AVAILABLE APPROVEDIL DATE 24 Apr 64 SIGNATURE OF PAYE . OBLIGATION REFERENCE NO. 2neri 'CHARGE ALLOTMENT NO. 4125-12V0-2902 DATE SIGNATURE OF APPROVING OFFICER . 1. 1 SIDNEY GOTTLIEB DC/TSD $ , PAYMENT RECEIVED IN THE AMOUNT OF S DATE , SIGNATURE OF AUTHORIZING OFFICER CER,IFIED FOR PAYMENT OR CREDIT DATE SIGNATURE OF CERTIFYING OFFICER i; 11 I DATE .! SIGNATURE OF RECIPIENT SPACE BELOW FOR EXCLUSIVE USE OF FINANCE' DIVISION ' PREPARED BY 'ftEviewED. BY 111 %FIDUCHER NO. 7.12 1; OFSCRIPTION.ALL OTHER ACCOUNTS 13.33 .,.39,, 140.42 43 r45.45 AY PER. 47.52 : R2,1'11,136 53i1 GENERAL 11 , 58.57 . ALLOT. OR COST ACCT. NO. 58.7 OUE 'DATE n�. . ...'.. CLASS 71.80 AMOUNT .CRIPTION.A0VANCE ACCOUNTS .....' 13.27 TA Ho. PUM.ORDEA NO. c -..5E7N PROP. NO. EXPENDPUNC6' CODE LIO. CODE ./.8%7AACE CA ACCOUNT NO YR L.P. No. LEOGER ACCOUNT NO. 6 , CK82., P42 A REF.. NO ..0 PROJECT NO. FY 4 a ... 1 II , .. , ::: . 1 ' ........ TOTALS I. I 111111111101111_ lallirENESIMBIOMMEMEIr _...�15�11�������. For services rendered; April 196!, I have examined and a 5' ' ho sulmItted--- - expenditures. 'SD Brannh It/N COM:WI:WANT PKAIWACti.L,OGY At) TOK1 11 April 1964 $500.00 11- Ci /1-/--te,' 31 March 196, PROJECT CRYPTO : MKULTRA 148. INVESTIGATOR : 0 RENEWAL DATE : October 1964 1. This project provide: r the utilization of the professional services of Dr. Since the initiation of this project he has proved to be a reliable source of information on the pharmacological and physiological infor- al chemical compounds of current interest in program. The information provided has been ltaining and advancing our knowledgeability of unpublished data and-information which permits us a better basic understanding of the sites pf action of mat- erials significant in influencing animal and human behavior and guides us in selection of material and experimental techniques. 2. He has reported on detailed experiments he Was us- ing to demonstrate that high and low spinal sections block- ed the action of a dimethyl heptyl substituted tetrahydro- cannabino1 on the polysynaptic flexion reflex whereas the mid brain section did not. The site of action is indicated in the lower brain stem. 3. The consistant depressant action on these reflexes is probably due to a summation of possible depressant act- ions locally on the reflex system and at points in the motor facilitory systems. It is hoped that work in this area will eventually identify the mechanism responsible for the ataxia produced by high doses of the active prin- ciple of marihuana. 4. The long latent period experienced in the use of C-9 may be attributed to the mineral or vegetable oil veh- icle which is used frequently in oral dosage forms. 5. Attention has been called to the diethyl:mid� of 2-methoxy-4-ally1 phenoxy acetic acid which possesses a narcotic and powerful analeptic respiratory action. It I (1/ 6. A por f the was given to D _or review and cr ne';� port is of co le -interest if. des- cribes interactions between pesticida ch als and psy- chotherapeutic compounds. .The.-iiesticidal chemicals are of the acetylcholinesterase inhibitor class, a class which in- cludes our CW or phosphate materials. Pentobarbital and 1-Naphtbyl N-methyl carbamate ("Sevin") (a reversible anticholinesterase material) gave directly additive respon- ses. Chlorpromazine greatly augmented the response to "Sevin". This was not related to changes in the brain cholinesterase no Pilocarpine which does not blo k cholinesterase increased and prolonged the anticholines- teraseaction of Sevin. This pattern offers in possibiliti teraction among materials of more direct interest t causes stronger respiratory stimulation than that obtained with most analeptics. 7. Dr. is summarizing the latest information and the state o ie art in-setting the stage for and trig- gering epileptiform seizures in mammals. He will maintain his contacts in the various domestic and overseas labor- atories with a special a within security on those phenomena of interest to S. Dr /ill continue to provide professional services, re d set up protocols for critical pre- clinical animal testing, will_seek_out sources of inform- d provide data available on direct request of whenever data_or_information isl ed to him e believes will be of interest tc Receipt is Gceby acknowledged of Treasurer's ck d t d April 9 1964 - the DATE I IC- (Wh:IMP.01,111n) I REIM' RSEMENT VOUCHER FOR PURCHASES AND NAME OF CLAIMANT r '7-.",�-. r,,,::,' ..:,, 1....,-.� VOUCHER NO. (Finance use onJ)) SERVICES OTHER THAN PERSONAL 'CHARGE 1 TO ALLOTMENT OR PROJECT ,, ... r, 1 , ,,^ ,,, .. eno, '',.. - , ,.,.., .... ....A,..1/4e . .,... J REIMBURSEMENT OR PAYMENT IS CLAIMED FOR MATERIALS, SERVICES, OR OTHER EXPENDITURES ITEMIZED BELOW WHICH ARE PROPERLY CHARGEABLE TO THE ALLOTMENT OR PROJECT DESIGNATED. 1 c... DESCRIPTION OF EXPENDITURE . ATTACH RECEIPTS AND OTHER SUPPORTING DOCUMENTS AMOUNT � 4114.1.11, 4' , 41 ,.., 44,5 r 411.4 NWOO ,.: , ...* ,rof,;:n1,-,1 - . etry 4. C. ez, rorecriNT..4 .....,...�......0, �:....,..,,..,noj.,_ -,,,, ...- '''',, :-,i.....0., 1:::.*:.'t t ) 1-`1,..*4 7...;4'..."rt .. 1.-z.,2.0::"Le az, ',Ivrl..t cf 1:17.. r.7..1.,;'..T.r,...94 :::1::::rra, ::.r.t.", loon din'h�;.trzcd for vi iez, srA,.� .-vicnn or tr.ntoricas have 177.tic.141 ;4:1z.-1.';',,I,.::.14I0::::,;= I.; ;IC, 11.;174:. il ZIT 0 ,It afr,.nt `,), f,r,,u1 in tho fiLles of TrE.7 fo vill heo men tvailL1-..lo to tho cortif.71,nz, cifi �. .,,,t his re- 7:::"- f-t; 1:,!:,:74,:cr f7,:c% 4t, �:;;.:. . 1.4 .i., 4.7.,,.., 1 tr. I 3 e!'rei ...t.A.ir * CERTIFY THAT THIS VOUCHER AND ANY ATTACHMENTS ARE CORRECT, THE EXPENDITURES WERE INCURRED ON OFFICIAL BUSINESS OF A CONFIDENTIAL. EXTRAORDINARY. oR EMERGENCY NATURE: PAYMENT OR CREDIT HAS NOT BEEN RECEIVED. AND I SHALL NOT BE REIMBURSED FROM ANY OTHER SOURCE. I CERTIFY FUNDS ARE AVAILABLE APPROVED t DATE SIGNATURE OF PAYEE OBLIGATION REFERENCE NO. CHARGE ALLOTMENT NO. DATE ,, SIGNATURE OF APPROVING OFFICER PAYMENT RECEIVED DATE 1Si GNATURE OF AUTHORIZING OFFICER CERTIFIED FOR PAYMENT OR CREDIT IN THE AMOUNT OF $ 1 4?Pr DATE SIGNATURE OF CERTIFYING OFFICER 1 , DATE SIGNATURE OF RECIPIENT SPACE BELOW FOR EXCLUSIVE USE OF IFINANCE DIVISION PREPARED WY r REVIEWED BY 1 VOUCHER NO. 7-12 .sCRIPTION.ALL OTHER ACCOUNTS 13.33 34-39 I ,40-42 4B 45.A6 . 47.52 .5 58-57 54-57 68.70 71-410 DESCRIPTION-ADVANCE ACCOUNTS 1 26 .33 TA ND. STATION CODE 'EXPEND ' "DS PAY PER. oeLI. REF G . NC. ...�1Ay, . CA GENERAL ALLOT. OP COST ACCT. NO. OUE DATE AMOUNT 13.27 pDR.ORDERNO, CODE PROP. NO. LSO. AccoumrA4. YR LEDGER 52.67 E. KO. ,.., ' 34.33 , r,, 1 PPIC.JCOTNO.1 r CODE Emp, No. ACCOUNT NO. -- A REF. NO. jgct CLASS _ OEMIT ERED I T 1....�.....,�___ '' : TOTALS FORM a,ag USE PREVIOUS 6-59 WI' EDITIONS. For services readered, Hrch 1964 certify that services or W' " satisfactorily receivail were. incu:red on offici. For services rendered, February 1964 COSsOi.VUL1 ANT PI 4AR MALIOLOGY AND TCOC1 4t,,DelY 0250.00 CONSULTANT ASMACCLOOy AND TDXICOLCR.Y 13 February 1964 $250.00 I certify that services or ';% �r.rla..s have been - satIsfactorily rooelvod 1,,1 fl'r enditures were incurred on officil1J,1Mnss. Plop_ . RECEIPT Receipt is hereby &owledod of Treasurer's Check L10 11 of $250.00 NAME Date_ileakyloAA 6 (When F4,14ed In) 1 NAME OF CLAIMANT . REIMBURSEMENT VOUCHER FOR PURCHASES AND VOUCHER NO. (Finance uee only) SERVICES OTHER THAN PERSONAL 1CHARGE TO ALLOTMENT OR PROJECT I , ! ' , .. ; ,': 7., � ,..": ;:::: :: REIMBURSEMENT OR PAYMENT IS CLAIMED FOR MATERIALS, SERVICES. OR OTHER EXPENDITURES ITEMIZED BELOW WHICH ARE PROPERLY CHARGEABLE TO THE ALLOTMENT OR PROJECT DESIGNATED. . SCR/PT Y 7NDITURE - ATTACH RECEIPTS AND OTHER SUPPORTING DOCUMENTS AMOUNT , Icnt tu, 1:.... Q' inv4.4,:ce 0 4. for zcrsic.1.,n1 (4.rvicce.: retorc6 ',':::,,..7.7.4 :.'ize...a71, !,�5:::!�...n. I certify t7":at Lo, 1-.....e tczt 0.1';.'� t,...nrilcd�.7c .,2:-!6 ..,:..,12.,,fg Vio r,,,,.z.out cb6vn 1-iz,.s :::;,c,c71, die:,vrsce,.: Ior A.,--, -,------r1C.f, 1-,;,--c: e 7.,....-,,t-e,- or ,.'.vii.*:,ri.nl,t. 1,,T,:.47... t:i -tccivcil. TI".c '''�:.,;:::;e6, %.�,%�,: ::,1,;.i:;�.:;