Standard Form No. 1034a
7 GAO 5030
1034-206-16

PUBLIC VOUCHER FOR PURCHASES AND
SERVICES OTHER THAN PERSONAL

Use continuation sheet(s) if necessary

D. O. VOU. NO.

BU. VOU. NO. #42

U. S. Army

(Department, bureau, or establishment)

Voucher prepared at St. Louis, Missouri

(Give place and date)

Payee's Account No. 23 2464 3235 64117 Discount Terms

TO WASHINGTON UNIVERSITY

(Payee)

Lindell & Skinker Blvds., St. Louis 30, Missouri

(Address)

PAID BY

Contract No. DA49-007-MD-1024 Date 1/1/59 Req. No. Date Invoice Rec'd.
Shipped from to Weight Govt. B/L No.

No. and Date of Order	Date of Delivery or Service	ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary)	Quantity	UNIT PRICE		AMOUNT
				Cost	Per
	April 1, - April 30, 1963	Direct Salaries Direct Materials Other Direct Costs Overhead				$ 500.00
						4,338.37
						18.13
						219.00
TOTAL						$5,075.50

PAYMENT:

COMPLETE
PARTIAL
FINAL
PROGRESS
ADVANCE

(PAYEE MUST NOT USE THIS SPACE)

DIFFERENCES

Amount verified; correct for.

(Signature or initials)

MEMORANDUM

ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown; other classification optional)

Paid by

Check No. __________ on Treasurer of the United States
Check No. __________ on __________ (Name of Bank)
Cash, $ __________, on __________, 19 __________

☆ U. S. GOVERNMENT PRINTING OFFICE: 1960-556840

Source: https://www.industrydocuments.ucsf.edu/docs/tjlg0227