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(When Filled In)
REQUEST FOR ADVANCE OF FUNDS
NAME OF ADVANCEE
DATE
AMOUNT
VOUCHER NO. (Finance use only)
MCULTRA 52
27 December 1962
$400.00
PAYABLE TO
ROOM
BUILDING
TELEPHONE EXT.
See attached payment Inst.
121
[redacted]
2941
PURPOSE
Advance to MCULTRA 52 Invoice #20 for activity approved by Chief, TSD on 6 November 1961. Accounting for this advance will be in accordance with Attachment A of MCULTRA Fiscal Annex.
Pls. forward check to TSD/R&D, through TSD/Budget Officer, no later than 10 January 1963.
I agree that I will fully account for this advance by submission of vouchers and refund of any unexpended balance to the reporting point stated and by the due date checked below. In the event of my failure to so account and refund any unexpended balance, I authorize deduction from my salary to effect settlement.
STATUS OF OUTSTANDING ADVANCES