Dear -'

Enclosed is the signed receipt which you requested,*

Due to the fact that your letter was addressed to

it was delayed in reaching me , That was an

apartment from which I moved aboufe| iyears ago. The fact

that the letter did reach me shows the cord ial relationship I

have with ray local Post Office^=l^r=presenfezaddress is as above.

I telephoned your office today because I felt that

by mail there night not: be time to make arrangements to meet this

week. Furthur I was not certain by your letter whetheryou felt

that such meeting was indicated.

/

Thank you for the notification that my project has

been approved, I understand the stipulations. I am resuming

December 3> 1953

Enclosed la a check for^OTOO In payment of your last

;

Invoice. Please return the receipt to U3. .

'•>

.. With best personal regards, I remain,- • _• > -.'-y')'.

'

/ X; Sincerely yours,

-•* $roi®Y_OpTTLIEB:;

Enclosure

f V/

throu^i Tf^Budget .

'

v''i

:

._

•'•'- .'/ : ;

TV'’:"-^': SIDNSY GOTTLIr.13

. .

-

: .'

y .

>V': v > ;V;%'; .>-;. • ' Chief •

•

::Jv :

V.'y' ;

- OheaicallDivisiori^ TSS-'•'

Attachments!'""

'

:

:V." r \v ',:Tv

' :? :

Z'

;.invoice ? .• %v

- d* 7, '.‘.y,..; -? y7/^

?y•/-;' yy^

Certifications v- ',-f--, \ T’ >.v^

Distribution; .. .>/•••".

" y :•'; y;y •' 0’ r "" v v-

: '•

Addressee - Cri2*iA_l.?- _d /^.^d>,y_'L,y C -

‘

Comptroller ** 1—' .

•. "V -V- • .’/ -.V .-..•••

.

• \TCr/Budset - l'*<“ •.

-. • ;• ••'

- •

;

'.

'

ldS/Kegiatry .'--V/

" \,yAyy \ •.

Exec, j~ 1

• TdS/CD - 2 '•;

(1) "It is hereby certified thhVihis is Invoice To,. 7 applying tosubproject U of fTojcct I'XUITFLt, that technical pcrfoKvanc© by

has been satisfactory, that the work was • accortnlished In'

accordance with ..the . cutual agreement reached wi th .

that this bill is just and co3-rect rod that vayrcab thereof- .has not'yet been r;ade, - .; -

•..-•

.

- 'v.

(2) "It is hereby certificdrrthat this invoice applies to subproject T-4 .'under Project ^ll4¥OfKieh" was.iSIl3

r''Sppsio,Sfe'd ‘and that the project T

has beer, carried out in accordance with the DP/P lse;aorand\ia .to COX ; •./

dated 3 April 1953 and the DCI icousrarfun to ,Lh/». dated 137.pi*il 1953*^Tajnsent is authorised and requested. p>;- - ^ \ . , V

. .

.;* ;••

(3 ) "It is hereby certified- that the scope of the prograa of subproject

4 of Project S AhllRa has been approved.^: ^ .7 ?.,.

“i-4

(

22 QW&te*- 1933

'' r .Ai -

• HK-; >-

*eK£R«nyj3 roar crisp,' putAios pzvmos 77 4: . :. V \.;

?IAt •' T'1?"?’-

'''i-’viV

SWWSQlk_

- ‘Xavoi««- 2?a*

la^oScs Sa» 6 for Suoprojecfe A, project: HSULT8&** is attached.:

It is requested that pay«mb bo eads by cheek for $eOO,QO fisodcTout

« .Tha chock cho*Ud bo con* ‘to Chief,

gli I^S/mdset Office?.: ,'

•v.w 7: ssam-ommu>̂

*

‘4 Ckffiaic&X Pivisios/ ?S5 '

Attac&entas \."

- v-‘ 4.4 -v

Tavoico • • 4: CorbificatioKa •/• '-h:.:*-

t

•

'"*

**. ?.

MstributiCKj -.'?;'*}%

A2d*o3 -3sa -.oris, & X," Coastroller L,

- X / •.. .

KS/Hcoistry *X4_Vil^cwc. cos ’y. jlMSnS&k

'

TS3/i50 - 2

:

. »; \

OCT 2 7 EIII O

» < '4

'i,'i

li'LUni. i ^SECURITY! INFORMATION

CEriXmcATionn

(l) "It ia hereby certified that this ^3 Invoice l?o» 6 applying toh of Project technical pcrfcrtsanca by

ffijjffifjPBfc- has be«a satisfactory, that the writ

accordance vith the eutusl s^essnt reached vdthli^lsWWW^wfctthat this hill da j'oat and correct ard that payment thereof haaact yet been sade. , ,v v

• •. •,

_ ' =•.- .'

fate:'J‘XD(iiu'£ GOi** £»lil

•:

* \ Chief, CD/SS3'*

(2)

"It is hereby certified that thia Invoice applies to subprojsk 5»lcr ftro'esf I-XJD'Kvl vhich vaa duly approval cod that the projehas been carried cut in acccr>lacce vith tee DD/? t^oraftd^i to 1C 1

dated 3 April 1953 ted the £C2 y.eriorsndtai to -PS/A’ dated, 13 AprilIIPayment is.authorised and, r«y.m1^»t^--—-----c:.

.

'

Sato:..... .

_V-‘.-.-Y-. </ ; -v-Vs - 1

rT'Jjrvi.. ;. 5.— <•?**

r ./-:,•• ;vO ;

-;- Y.‘.YJ ’-.'Vf,. jtesearcli.Diracto#"

(3)

"It io hereby certified. that the scope of teo presrau of subprojeo4 c.f Project ":C^/SA hao been approved.

Date:

Exec, lieejy..

00 r y

October 22, 1953 ^

Dear John:

Enclosed is & check for $450.00 in payaegt of yo^s* last;

Invoice . Please return the receipt to xiq. .:. -fC.

; With best personal regards, I remain,-

.’ V-.

'• V' V : V ; !•

'7. Sincerely' yoiira,

Enclosure

ZO SIDREY GOTTLXEB

MEMORANDUM RECt I PT

FROM: Budget Office, fSS

SUBJECT: Check

~ I hereby acknowledge receipt of the following:

« Check #ML3519U in the aourit of $K50.*©0 parable t

as payment for invoice #5 subproject 4 Project-- *<r*

Floats raturn. .sigaoJ copy ties) of this receipt

Z ( 0^ 3DATE RECEIVES

i . V

<

#-/r

.3 October 1953

3

B2^0RANDUM FORI Cim^, DIVISION - <•

.'-'fi"

^

*'V‘ .

. ‘*

YU:. v -.;, #S/Budget Officeirr^r.

"77IZS:’'’ •/. v; •’ ’

.

S&BJ2CT: Invoice Ko. 5, Subproject 4, Projectmn*^ r'A:r^i.-X~'

Ia?oico 5 foriSnbprojsot 4, Projocv !£3JLljLVis^ttached.'...

It ia rsnusstod that payinoat bo 1^40; by ohaolc for $450.00 inadaT^”' •=. -

out “2Jia check should be • saint : to .Chief,-• -CD/

TS3, through ^S/Budgct Officer.

5

\-v~- siPtisr.dbTTtisB'' V • Chief

’

Chemical Division, TeS

.;"•• Attachments :•

'

,. Invoice 7

Certifications

Distribution:•Addresses - Orig.& 1Comptroller - 1

TSS/fudget • 1 ^Ihtec. £ecy, * 1

53S/RoelatryTSS/CP - 2

JK. I

v 7

OCT 8

(1) "I* id fcoraty aartlfiod'-thnt this i« Xnvotao i*o».5 applying '7

to nibriyiv^t a of Yuo-lcst tliatk..t^aivdC B.l T-f!rCoc?^nga

bo&n satisfactory* thot tho v-ork was r.c-

ln.*a.-;or-J<---icQ 1 th ir.u Lutu.~:l li&roorjiiit rocehod with ;7

that »la bill Is just and correct uml that ?fi/»

sSSttooroof• haa not yot boon isado*. \ , -V--

.

I-ato t

“7.. ;y fiomiun,••; chief, op- ‘sss

: ;

(3) "It -la fcareiT-certified' ihTt^frisTlnwic^osplIoa to. cub- -

project 4 under iro'-tet fe'S/lTa-ctmicfr.^aS duly approval cad that

tbo project hao bsoo-oovried .cut in aceordunoo with %\ia l’*/?

pororandua to 1731 dated 3 ^ril l^SIcnd tho 001 oasowadun to

BB/a dated 13 "April- ISSSt^sy&ot la authorised and^iuostod*-. •.

Cato 5

i‘osoa x ch piro c tor?

(3) *lfr la Wrafey certified .foot ''tl^Ooepo ©f: tfco7pr0fB*3» vo# -wk?project 4 of fvojoet »-7AilAw »\ fcaa fceort"OWrotrcd» 1

,; ;

:

. •* 7 ;

DRAFT-RVL/11118 September 1953

MEMORANDUM FOR: THE RECORD

SUBJECT: Amendment to Project MfCUMPA, Subproject k

Subproject 4 involves the production of a manual by*

2. Tbe time period of the original proposal

was six months , which would expire about 11 October 19^‘p

T^ ^U^1

n,f„« «** km a manual demands that it be a creative project tase!* 0*

.| rather than a mere compilation

reason timeestimatesare

difficult to make in advance and it is apparent at this vime that the

catimlte was Sfshort for the adequate preparation of this

It is in the best interests of the Agency to extend

and obtain the best possible manual rather than to hold«^@^gppj?^

to the six month period. ; .

3. It is requested that the original six months

extended An Additional six months. There is no change in the; original

cost estimate or the -original agenda.

cal Division

APPROVED:

Original Only,

PROGRAM APPROVED AND

RECOMMENDED:

APPROVED FOR OBLIGATION

OF FUNDS:

Research ChairmanResearch Director

5

i

*

t

Lf'

I

4

I

1

September 18, 1953-3. -m

This is at least, a partial^ansver to tbs -.questions you ashed the^ .*

last tine I saw you.' According to my records, your initial estimate was

’

.

six months, vMch would e^r^ IWiMtiat sThix 7months extension of the originaljestisate, which should nor© than take

caro of time factor. Thooriginal cost estimate was $3,000.00, of which .

:

^^CO.OO is remaining as ofnov (this of coarse does not consider the.- .

.;invoice i expect to receive in a fey days) . ,

1 './•. .

'

; '• *;u. . Sincerely yours/

>

smmri oct?A33

i

19 August ly?3

cais?, m\acs divkios

ct, Officer

SWWSCTft X^volco .\0. h $ Subyi’cjfccti 4, Placet MKK^M

Invoice Ko. 4 *oi* S’.f>pr©4e<st 4, 5roj«et fSUJffM la attach*

t% is yegtaftistaA that gayaattl; be.,c&&3 byaha<& for >4$0.00 «sod© sv*.i

Tho oheefc. ahculd be neat to Chief* 09/N&* v.

ibreu^sss/sui^jet Off^ '

'

V\

'

';;T /.

ht+W+Hai «V**V**»tf•.

^

. Chief '• ,.;'•••

Chemical Division, ?33"

Attasheants* ;.

:

• savoice .,.- •

Conifioati^s ^

:

Distribution! ' -

Ad-Srtweca ** Orig* & 4

Comptroller » \ '

£»»TJ-7/;lS3lfltsV - 1233/53 - *

AUG 2 0 EHT'O

.*

'

v V-

CSIffI?I^ATICJT3(1)

"It la hereby certified that this la Invoice No. 4 applyinc^suhpro.Wet h of Project hftQ&TBAr

.tliat tccJ^coX-^tXoiwanoe ^JH

qjfMtfjNittMhaa been satisfactory i that tha worh vaa acccnpUet^x in

cuscprthuica with tha mutual aKroesant reached with J

that this bill ia Just ard correct or.l that potent thereof hsa

not yofc beta sisde. : . , ... .

•'

. Chief, G

0

‘fST

(2)

"It la hereby certified that tMe invoice appUe 3 to subproject

k under ?»*> 4ftafc -wwmk' chioh- ttaa duly approved and that tfco project

has been curried out in c^coraar.cejrlth theL^PD/Plmnsra&lisi to DO I •

dated 3 April 1953 sad the WITscsgoiisdua to B'D/A dated 13 April 1953

Payment la authorised and rcQuested.—;_: •_* : :•_-=:

: ,• :

\ .. .

*-

•• Research Director

(3)

"It io hereby certified that tha ocopo of the progress of euhpro.jcct

4 of Project IffiyiTOA haa boon approysd. ..

'

.

; t t r\

Ixcct Gec’y.,

, «rfe-

S3 July 1953

xanRAZBXti for* caisp, pisaws 'sr/£3ien.

.

i- /*: ’Y" .

VIA* tS3/2a4Lg<it Officer >-*'

• '• •

; '

SiEJECT: Xwroloo Ko.“3i -Suhpro^ocfc h, Project; KHULmz :VYY:_Y

Invoice Ho* 3 for Sx&srojoet k of Project J50JL*2RA. 18 attached* /, .

St i» requested that jgaycaaVbo aaado hi? choe)t for 3500*03 cade out,

-t TIas chock Quould bo cent to Chief> Ci)/?C& . .; .

through sss/soiseV OSttwrcr^:^ t;‘ ' ;7: 77.7 '

7.,' :; -

;.•••

Mteiehsest: ' v Y-v;

.

Invoice :

;

' > .

Cortificatiosa ---.:•7 . 7777777:

Y km^-<xmv&9Chief

Chosicol Division^ T33

Dlstrthutloci •

AMxti3Q9Ct » Q'’

ekc-jToc *y«

f

?3~/2u*£St - 1VoS/CD - a

' TS3/Koslstry

6 1-

1

JUL 3' 1 1953

C4

1* VAI

»'•«. . T...

;V

CSSTIFK/WMOna

(l) "It In hereby certified that this 13 Invoice No. 3 applying to4 .of Project HKUL3&VJ' that tdtfcalcal porforcaf.co bymmm *3 satisfactory, that the work is beins occasplished in

accordance with the cutual agroeaent reached wi th,

that tills bill is .just and correct arsd that pc^eiitj^^reoF aaa no

t

ret been cade

»

r)’ v. S K*j:, vi

.V?. , i'*: •>* v-* r - -

vj.-t/*

tc®c._oe

Sr

?av !‘><'-.’ik 'V

1

' *’

*•'*•/.:

.-5 t.AVJfv^a 'O *H*- tej- V1

\ ‘ t-«-* VJ

;

?-a

Avgust 7, 19?3

Enclosed is a check for $300.00 In payment of your last invoice.;

We would greatly appreciate receiving the receipt hy return Ball.

.

‘ With host personal regards, X remain, i „ \.

;ir

••• v-’ - . Sincerely yours*

SXDIE2Y. C-OJTLIEB

Enclosure

VIA? ?33/Budset Officer" ' * V*

SUBJECT? Invoice Eo» 2, Subproject 4, Project ISCUITHA

levoica Ko, a for Subproject 4 of Projost KKULTRA is attached *

It is related that payment bo cade by.cheek for $300,00l cajo out _ . i

Tbs check should bo sent to' Chief, . CO/733,

•,

through T3S/3u4get Officer. \'

: v

1-

j

. 3ieasif.C-0TTL3S3

ChiefCiieaical Division, 733

4

AtiacbscatJInvoice -

Certifications*

Distribution!Addresses - Crift.J’i 1

.' Kxee. Seo’y^YTdO/dJciset - If?"

. T33/CD - Sr7o3/r.e^istry - i

I

i

JUL 6 EHT‘0

',Gii-Ol

czK2WJS?!dora

(!) "it io Seroby certified that this is Invoice tto. 2 applyletj to

BubBTOisct h o? rro.’cot MirJtT?w\, that fcjchftioal parforaoaee

g^gPgfe is satlaf&ctciy* . that .t&e work ia hairs f^a^lisbod. i.a .

c^ccrOoncc with tfco cutr-ol o;-ro«sent reached vith jjfjjji|i|^that this 'oil! is just and correct cud that payaeat thereof Las not

yet been wide. •., • ..;•

r&tosi" *' »* v- T\ji >' • 'TVJ ’2

VVi

Chief, CD/ilS3 :*

(2) ”It is hereby certified that this invoice applies to subproject

4‘ wri5S*'"?ro.is-3 % lhnj?xi vhieh vas duly approved sad that the pro loot

has been c errlei out in accordance vit-L tl^o Bp/i* sceorandvCi to £CX

dated % Abril 1933 and the PCI refflorandua to SO/A dated 13 April 1953

gg.V; . ,* yVIA'v'jb* » *• *». “* h* -V- „V.^ V.t^:»’«f ** t« V « *

Seseoreh Bireetor-

3) 'It ia hereby certified that the score of the pro^rcci of

ubprojoet 4 Project dCrumtU has been approved*-^....

July 10, 1953

' Closed la a ehecS far $300.00 la payocnt of your last Invoice.

We would greatly appreciate receiving tbe receipt by return mall.—

With teat personal regards/ I rca&ia#;

Sincerely yours,

.

v SIDNEY GOTTLIEB‘

’

'•

Enclosure..

. ;;

9 Jaaa 1953

isia’Aasm roa* cats?, pI'flSIC it ,. 7 .

via:1

. / *33/EalL^t. Officer 7^

g^jsc?: Invoice Koi 1, S'ibjrojecfe 4, Fro’®** xzmxzh

Invoice ». 1 fW ^rojee* 4 of r»J«* WSUVX 1* &«*«»&' 7

1* la req^stei thfct-s^s* .

;^«^^y.a

Td>e?^ *» $453.00 *>

ijfee c'?5-a'i ahculd.v-o sent ,© CUIe£# CD/133 » tiisougli-

Stsig^ ®ffi«r/'!j3»''

:

: ‘ — ~ “v- “.“t'—;"

•;

... SEJSSjC uCCTl»132

CSief.Cfcraical Division, 533'

Attachments:

• •

invoice .;

••:

Ccittficntea

DIstrIl>utioriS' " :

Acldtessa© - erig. & 1

*;see. foe '/.

;

5$3/3ti&jOt Offissr>. 1jkfT.

T33/?jesi»try - 1

•rr«» *•£? -*

CSZ?T?I2fi?IC'-3

(i) "It la hsct'oy certified that this is Invoice Vo, 1 cr>o^arto^gwa^ee^of^leat KJO&TRA, that technical perfeRs»ee*by- -

BaBgMwJpiiwKGffi i-O-3 tsen s3visi&cioi^j^thzi?r the vorI» vas accctoll shodIn accordance vith thc.ssttual fc^eszantthat this hiU is just &n<l correct and that potent thJreofSnSyet toon sale.

.

*

Date:

tfEXSlf OVjfTwEB.Chief, CD/7$3*

(^)__

I'-* Is feerec-y certified' that this invoica epplios to eueprojoct4 under Project JSULT3A vhich v&o duly approved a^d tbat=tivc^ero'eet Jiaahaea carried cat in^cacMasea vitS the i5/T metz-ovsxdim to DCI dated3 April 1-53 and the DCt reaorandua to ay/A dated 13 April 1253'.PayEast is authcrls^d aM i^equected.

’:

, JUr^ -•’

Research Director'’

(3)f‘lt is hereby certified that the scope of the prcwca of

stfbprojoct k of Project S€OE.TM has VManppmvea . - - - : : - -

j

..June 1C, 1953

I have enclosed-* check for. ^50. 00 to cover your latest voucher.

Please sign the enclosed receipt and return It to no.

I oil working oi^e^ta. you repeated, f and I will" get it to you

In a day or two. vi ..

Very sincerely yours*

- V. SIDNEY GCTTLISB 7-~ :

~

Attachment!.

'

DRAFT I

4 May 1953

MEMORANDUM FOR TEE RECORD*

SUBJECT: ' Project MKULTRA ,Subproject 4

1.

The scope, of this subproject .^is;

^the__col_lection i-in the form

of a concise *n

&g*&fflg§$gg' liquid, solid, or gaseous substances to 4S^j^S»- subjects

.

2. The information will be collected principally from the previous

studies made by connection with various

problems he has considered. seems well qualified to.

execute this study. _: He has been a successful of a11 forms °r

He has made a careful' and exhaustive study of

^^ Msto^' of urestidigitation and is-the -possessor of on extensive

library of old volumes in this field. Re has farther seriously studied

the psychology of has instructed

graduate students in psychology at

3 . The period of time covered by this request covers six montns

from -the date of commencement of work by Mr. Hulbolland and the costs

will not exceed $3,000. The proposal covering the vork is attached to

thi s memorandum . - u ^Jy*

SIDNEY GOTITIE3.... Chief

Chemical Division, TS3

PROGRAM APPROVED ANDRECOMMENDED:

APPROVED FOR OBLIGATION:

OF FUNDS:

: v' 7>f

4 Hay 1253

j&josiAHS&s ?oai ccstPEfc&tsR v

r

::r

—

A2SEICI0H* Finance ptviolcA «,..

.

SU3J3CT*.'

Project *>

l&4or the authority granted la the mserasl'Ji dated 13

April 1953 froa tie DQI to'_th«_j?p/A .and the, -further authority

grated t» the asserai^ua fatsl 17 April 12>3 f«a *ia5 to

the Ccapt+oHor- on the ou\!cot> "PD/p^Tjo Project > T

fP^mrojtvat U hag Vson approved end ^3#000*W-of-the oyer-all

Pro tect tcafLl^'Cte^o .hays teen ohUgated' to cover the ouh* -

project *s expenaaa. . V;\- v v

FRQ53AM APPdOVSD:

AID imJ&dSiSJDs

Aeso&reh Coat nasa

»***!: .

*

. V t » •

.. sese* Go^rtKa^^:

'-/ ... .: . Chief. .

. Cheatcol Di>d3ton> *03jp

^ - APP30 PCS 09I.J3A2I0N:

w FUKSl

I

/

Kay 5* 1953• .

The project outlined in your letter of April £0 has teen

.

approved by, us, and you ore hereby authorized to spend up .to

$3*000 in the next^ix months in the execution of this vork.

Enclosed find a cheek for $150.00 to cover the last voucher :

you submitted to us,; HsasT^ipc^h^SRClosed receipt andreturn it to me* •

: A very crowded schedule of travel mkes it necessary forU3 to delay until June 8tb our next visit with you. An effectivealternative to this would be for you toon Kay 13 * 14* dr 15 to disousa the current status oil' taevork

.

IS thl8 pOOSibleS i: i iu_ •

_. Very sincerely: yours*

Enclosure

rifre**5-r

X tfuna 1553 •

hsmosashm yoa* • cars?# ?u&S28 ©i?isi03 •-•• •-••-,

vxAt •mfmm o??EBa .. . . :

EIQ0/5T1 Payaant of Invoice oa Subproject 3# Project .WCULTA\

U FsyjaoA* Is roasted for ths attache* ievoicc. The pay^a*/;..:.

of $4X32.27 should bo «aa3o- la cam, eai poysonh ylll to ssais to

gggggfe. by’ Dr. ' Sidney Gottlieb# Chief# CD/JS3. - - -

2. It is yetr-tast^i that the fuada referred to above bo Kalo

available to Dr* Gottlieb by 4:3O P.M.- oa Friday Juno V '

.

SXMEX GOTTLm ;

.

ChiefChetsic&l Divioica, '133

Distribution I :-7V.—?-

Addressee - foil;i*

A

,EK.ec* 3cclyf#4SHPEP» * 1

933/5n&8»t Offlews*-“1

T33/CD - 2 ^ "•

*K3/Ro3l3try_ -

1

MEMORANDUM RECEIPT4 Juaa 1953

Sidney Gottlieb

from:

SUBJECT: MEUX/HtA

I hereby acknowledge receipt of the following:

Cash ia tho aaount of $4*132.27 for MKJMBA,

Pleat* return.

To _jmJ3fe22FORM NO. 3tfSMAR lt«»

etgned eopytUi) of tM* receiptsWisy GO'nmi> itj ’t( ° r R£c,f" £* T

Ji^~e (Tt/9(T )DATE RECE'VEO

MEMORANDUM RECEIPT

i

8 April 1951TO • f . DA

Sidney Gottlieb

FROM? Budget Offico, TSS

SUBJECT: $150,00 '

.

. i

I hereby acknowledge receipt of the following:

One check for the amount of $150.00 for the purchase of servicosand information in comectioa with

. —

Plaasa ratura algnaJ capy(let) of tM« racalpt

SIGJEf 0F R£c 1 p ' (HT

39- $6 .,9

p?r<- prt]i&

DATE fieceiVEO

MEMORANDUM RECEIPT24 April 1953

" OAT E

to: Sidney Gottlieb

from: Budget Office , iSS

subject: $150,00

I hereby acknowledge receipt of the following:

One check for the amount of $150.00 for the

^ and informticn !in connection with;

purchase of service_• •

_ _rM .... S

pi,..« r.tnr. 1' alaaad MPyd*») af thii racalpl

To0-ffj gft « 3SS hoom 2319 QIkOaJMsl

FORM NO . ..

MAR U4» ,6 '**

SIDNEY OOTfl/S®i/RE Of RECIPIENT

DAff RCCE'VEO

t. REIMBURSEMENT OR PAYMENT IS HEREBY C

ARE PROPERU CHARGEABLE TO:

RS CEH

that the exs«

,with officia

i any source,aspects.

d/or attached documents were necessa

re, and that I have not been, nor wi

this voucher and attachments, if any

3. APPROVED;

A. is mouther ^s^e^ined?y «*: ‘hat

such d^athlTnished wo, or a sat i sfactory explanation made -or the ur

f

er°[ie,essary official purposes, reimbursement or pay-

^nt^fhiM lhal SuCh expenditures are properly chargeaole :o

available appropriations as indicated below.

oate ' APPROPRIATION

5. ACKHOWLEDGMEHT OF RECEIPT

_2SH-ia_^allotment authorized certifying officer

RECElPl IS HEREBY ACKNOWLEDGED OF S,

for the purpose as stated above.

signatus