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