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(When Filled In)
REQUEST FOR ADVANCE OF FUNDS
NAME OF ADVANCEE
DATE
AMOUNT
VOUCHER NO. (Finance use only)
NEULTRA 52
7 December 1962 (A)
$500.00
PAYABLE TO
ROOM BUILDING TELEPHONE EXT.
See Attached Payment Inst. 121 2041
PURPOSE
Advance to NEULTRA 52 Invoice #19 for activity approved by Chief, TSD on 6 November 1961. Accounting for this advance will be in accordance with Attachment A of NEULTRA Fiscal Annex.
The check should be forwarded to TSD/R&D, through TSD/Budget Officer, no later than 21 December 1962.
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
DATE
AMOUNT
UNACCOUNTED BALANCE
REPORTING POINT
DUE DATE
FINANCE DIVISION - HEADQUARTERS
ON ARRIVAL AT DESTINATION
ON OR ABOUT
MONTHLY - ON THE LAST WORKDAY OF EACH MONTH
REQUESTING OFFICER
DATE
SIGNATURE
APPROVED
RECEIPT FOR FUNDS ADVANCED
7 Dec. 1962
[illegible] (A)
SIGNATURE OF APPROVING OFFICER
I acknowledge receipt of funds in the amount stated hereunder to be used for the purpose stated and accounted for as shown above.
DATE
AMOUNT
I CERTIFY FUNDS ARE AVAILABLE
OBLIGATION REFERENCE NO.
CHARGE ALLOTMENT NO.
CERTIFIED FOR PAYMENT OR CREDIT
SIGNATURE OF ADVANCEE
847
2125-1390-3902
AUTHORIZED CERTIFYING OFFICER
DATE
SIGNATURE
DATE
SPACE BELOW FOR EXCLUSIVE USE OF FINANCE DIVISION
PREPARED BY
REVIEWED BY
VOUCHER NO. 7-12
DESCRIPTION-ALL OTHER ACCOUNTS 13-33
DESCRIPTION-ADVANCE ACCOUNTS 13-27
34-39 STATION CODE
40-42 EXPEND CODE
43 F U N D S
45-46 PAY PER. LIO. CODE
47-52 OBLIG. REF. NO.
53 GENERAL LEDGER CA YR ACCT. NO.
58-67 ALLOT. ON COST ACCT. NO.
68-70 DUE DATE
71-80 AMOUNT
DEBIT
CREDIT
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