USE ONE SIDE ONLY. 
00 
Form 41). 
Approved by the Comptroller of the Treasury 
May 28, 1914. 
SUBVOUCHER FOR MEALS AND LODGING. 
No. 
To be completely filled in before signature by payee, 
and there must not be any erasure or 
other alteration whatever. 
Received m Cash of 
City or Town, 
Name of Hotel, 
Date 
100 
Dollars, 
U. S. DEPARTMENT OF AGRICULTURE ^nd 
for MEALS and LODGING from 
- — 191 , inclusive. 
Time covered, day...., at $ 
If charge for fractional part of day is greater in 
proportion it must be explained HEREUNDER. 
— per day. 
I certify the foregoing to he correct. 
(Signature) 
(DO NOT SIGN IN DUPLICATE.) 
(Title) 
