9“'9 
Standard' Form No. 1012 a 
Form appro ved* by 
Comptroller General U. S. 
May 3, 1929 
Pulilic Vouckr far Reimbursement of Travel and Other Expenses 
Including Per Diem 
Voucher No. 
No 
GENERAL ACC6UNTING OFFICE 
I g imitiiBmijm tetitetion - fiatior®! 
PAID BY 
PREAUDIT 
Certified for payment in tne 
Appropriation: 
1084 
sum of $ 
J. R. McCARL, 
Compirolkr General of 
the United States. 
By 
THE UNITED STATES, Dr., eld© t>ohsaltt. 
To 
(For use of Paying Office) | 
I 
(Address) 
— — — ._j 
Official Headquarters Domicile Residence 
(For use of the Postal Service only) 
. . . I Check No datrf 19 for S“‘ 
rrl riTr ' ""™ ■' i ' i n— I’.' . l." ■' — i , . 1 i. , ■ „ — ■ - '■ ■■ i . 
Paid by 
Cash, $ , on , 19 
MEMORANDUM~DO NOT SIGN 
10— 1664a 
