52-22
(When filled in)
Voucher No. (Finance use only)
ACCOUNTING BY INDIVIDUAL
FOR ADVANCE
SUBMITTED BY
MKULTRA 52, Invoice 18
PERIOD OF ACCOUNTING
FROM 31 August 1962 TO 2 October 1962
NOTE: Follow instructions on Reverse
RECEIPTS
1. CASH ON HAND BEGINNING OF PERIOD
2. RECEIPT NUMBER
3. DATE
4. DESCRIPTION
5. VOUCHER NUMBER
6. DATE
7. DISBURSEMENTS
8. DESCRIPTION
9. AMOUNT
3/31/62 Advance MKULTRA 52, Inv. 18 900.00
Invoices $ 900.00
I certify that to the best of my knowledge and belief the amount shown above was disbursed to or used for Agency authorized activities and services or material have been received, and further advances may be directed by the Agency are warranted. The documents upon which this statement is based are maintained in the files of TSD for security reasons and will be made available for review by the Certifying Officer at his request.
TOTAL TO ACCOUNT FOR $ 900.00
I CERTIFY FUNDS ARE AVAILABLE
OBLIGATION REFERENCE NO. CHARGE ALLOTMENT NO.
841 2125-1390-3992
APPROVED
SIGNATURE OF APPROVING OFFICER
SIDNEY GOTTLEB, DC/ASW
CERTIFIED FOR PAYMENT OR CREDIT
SIGNATURE OF CERTIFYING OFFICER
SIGNATURE OF PAYEE
(A)
TOTAL ACCOUNTED FOR $ 900.00
I certify that the expenditures listed herein and on any attachments were incurred for official purposes of a confidential nature, that payment or credit therefor has not been received, and that my accounting is true and correct.
SPACE BELOW FOR EXCLUSIVE USE OF FINANCE DIVISION
PREPARED BY
REVIEWED BY
Voucher No. 7-12
23-39
DESCRIPTION - ALL OTHER ACCOUNTS
34-39
DESCRIPTION - A/P ITEMS 13-33
PAYABLE
VOU. NO.
40-42
EXPEND PER.
LIG. CODE
45-46
PAY
OBLIG
47-52
REF. NO.
ADVANCE
ACCT. NO.
53
FI
LEDGER
ACCT. NO.
54-57
GENERAL
LEDGER
ACCT. NO.
58-67
ALLOT. LEDGER
ACCT. NO.
68-70
DUE
DATE
71-80
AMOUNT
OBJECT
CLASS
DEBIT
CREDIT
FORM 282 USE PREVIOUS
6-57 EDITIONS.
PASS (1)