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Standard Form No. 1034a—Rev. Form approved Ijy , * Comptroller General, U. S. May 28, 1938 (Amended August 15,1941) PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL F GENERAL ACCOUNTING OFFICE PREAUDIT Certified for payment in the sum of $__________________________ Comptroller General of the United States By- Office of Housing. Expediter U. S.-------------------------------------------------- (Department, bureau, dr establishment) 1355 MARKET STREET Voucher prepared at _ ....___5AM-EHAjN_C 15££L -C. THE UNITED STATES, Dr., To .....______..._____ D. O. You. No. Bu. Vou. N o ._ (Give place and date) (Payee) Address_________ Payee's Account No. PAID BY (For use of Paying Office) 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 sheet(s) Quantity UNIT PRICE Cost Per Shipped from ------------------------------to. . Weight. . Government B/L No.____________._________________[Total- JMI IIFFTM Kliipp US 111 il H -JL i Wii (Payee must NOT use this space) Differences ______—.—------------------ Account verified; correct for_ (Signature or initials)---------- AMOUNT Dollars Cts. Contract No. Date ;_______-________ Req. No. Date____________ 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 Paid by j f Check No_________£....________-i— dated-------------------------------------- 19------ Cash, $___________________________ on ——-——:------------rt—* 19---- Payee. \ payee named above. (Sign original only) * When a voucher is signed or receipted in the name of a company or corporation, the name of tj1® ® SSS'iiSf it. oanaoitv in which he signs, must appear. For example: John Doe Company, per John Smith. Secretary . or Treasurer .as tM eaw nwroeu __ t If abiUty to oertify and authority to approve are oombined inone person, one signature only is necessary, otherwise the approving offioer wfll sign in the blank space below "Approved for $——-------------- and over bis official title. U. S. GOVERNMENT PRINTING OFFICE IS—22900a-! £ '7 ? Per. Tide.