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‘ Form approved by f PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL Comptroller General, u. S. May 26,1038 (Amended August 15,1941) D. O . Vou. N o .. Bu. Vou. N o .__ GENERAL ACCOUNTING U. S...._______. . . .. ... ................... ......_________ (Department, bureau, or establishment) PAID BY OFFICE PREAUDIT Certified for payment in the FoadW pnpmJ at sum of $__________________________ THE UNITED STATES, Dr., Comptroller General of the United States To —hAsS—------------- By----------------------------------------- Addrcss_imk-M ---- Payees Account No.______________ (For use of Paying Office) No. and Date of Order Date of Delivery or Service smuti 3Peffen3»*3p Jill m Articles or Services (Enter description, item number of contract or general supply schedule, and other information deemed necessary) Terms________________% Discount Cash ----------------days Brought forward from continuation 8heet(s) For nail?' aervioe at 123 Soul U&ln St,, has Quantity a? UNIT PRICE Cost Shipped from_______:_______________to . . Weight. . Government B/L No.___...------------------— Total--------------- Per AMOUNT Dollars m* S fMMM UiSm & UAtKB SJ0 (rftnftTf'l Map-to&ixr*. (Payee must NOT use this space) Differences Account verified; correct for. (Signature or initials)_______ ? 50 Cts. MO Contract No. Date__________...____ Req. No. Date_______________IS Invoice Rec’d MEMORANDUM ACCOUNTING CLASSIFICATION (for completion by Administrative Office) Appropriation, limitation, or project symbol Appropriation title Limit’n or Proj't Amount Appropriation Amount Allotment symbol Amount Obligations liquidated COST ACCOUNT OBJECTIVE CLASSIFICATION Symbol Amount Symbol Amount f Check No. __ dated _ _______... 19____,for$_____________________-—_--------------Ton Treasurer of the United States in favor of Paid by < \ payee named above. I Cwh. $------—on ....,4...—.._-------1»—• Payee.—.----------------------------------------- * When & voucher is signed or receipted in the name of a company or corporation, tbe name of the person writing therompeny or corporate nameiU well as the capacity in which he eigne, mint appear. For example: “John Doe Company, per John Smith. Secretary . or Treasurer .a* the oaee may oe. t If the ability to certify and authority to approve are combined In one penan. one signature only le neeeeeary; otherwise the approving offioer will sign in tbe blank epaoe below “Approved for __and over hie official title. U. 8. GOVERNMENT PRINTING OFFICE 16—22900a-l Per Tide