SUBVOUCHER FOR MEALS AND LODGING, 
Form 4to. 
Approved by the Comptroller of the Treasury 
May 28, 1914. 
No. 
City or Town, 
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To be completely filled in before signature by payee, 
and there must not be any erasure or 
other alteration whatever. 
Received in Cash of 
Name of Hotel, 
Date 
U. S. DEPARTMENT OF AGRICULTURE and Dollars, 
100 
for MEALS and LODGING from , 191 , to 
Time covered. 
day , at $ 
191 , inclusive. 
per day. 
If charge for fractional part of day is greater in ^ Certify the foregoing to he correct. 
„ proportion it must be explained HEREUNDER. 
S (Signature) 
i (DO NOT SIGN IN DUPLICATE.) 
(Title) 
