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Standard Form No. 1034a—Rev. Form approved by Comptroller General, U. S. 4, May 26, 1938 PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL D. O. Vou. No. . Bu. Vou. N o .__ GENERAL ACCOUNTING OFFICE PREAUDIT ? ttegiqnui. ouugc u g g ? | . C/* S. —-----—r~,-----—?R-f’rO’ffi—988---------------—:-------------------------------- (Department, burea^i, p jstobUsl^nent) PAID BY Certified for payment in the Voucher prepared at ............... (Give place and date) smn of $ __ THE UNITED STATES, Dr, Comptroller General of the To ......_________________________________________________________ United States (Payee) Address __________ _____ ____ _______ (For use of Paying Office) By----------------------------- ------- Payee’s Account No.________________ No. and Date of Order Date of Delivery or Service Articles or Services (Enter description, item number of contract or general supply schedule, and other information deemed necessary) Terms________________% Discount Cash________________days Brought forward from continuation >heet(s) Quantity UNIT PRICE Cost Shipped from________________________to________________________Weight____________________Government B/L No.. Per Total. (Payee must NOT use this space) Differences ____________________________ AMOUNT Dollars Account verified; correct for_ (Signature or initials)_______ Cts. Contract No. Date __________________ Req. No.______________-______ Date._____________— Invoice Rec’d MEMORANDUM ACCOUNTING CLASSIFICATION (for completion by Adnunietrative Office) Appropriation, limitation, or project symbol Appropriation title Limit’n or Proj’t Amount Appropriation Amount Allotment symbol Amount Obligations liquidated COST ACCOUNT OBJECTIVE CLASSIFICATION Symbol Amount Symbol Amount f Check No. _ dated____________________________,19____, for$_______________________________________f on Treasurer of the United States in favor of Paid by < ..........j&SfijS .......................................... \ payee named above. (Cash, $--------------------------------on --------8----------------------------------19—., Payee--------£jfeg-------------------.................................................................................. * When a voucher is signed or receipted in the name of a company or corporation, the name of the person writing the company or corporate name«as well as the oapaeity in which he eigne, must appear. For example: “John Doe Company, per John Smith. Secretary . or Treasurer .as £he case' t If the ability to certify and authority to approve are oombined in one person, one signature only ia necessary, otherwise the approving offioer will sign in the blank space below “Approved for $________—”. and over his official title. U. S. GOVERNMENT PRINTING OFFICE 16—22900a-l Per________ Title