Form 4B, 
USE ONE SIDE ONLY. 
No. 
Approved by the Comptroller of 
the Treasury May 28, 1914. 
Subvoucher for Supplies, Lively and Miscellaneous Services, 
and Expenses. 
L Srjtartamtf of Agrtntttur?, 
To_rwwA_j Dr. 
J2Lj6L . 
_, 19li 
Address: 
For 
LAS _ J^teL aaa/x - 
3 /33 ^ 
33 
Total, 
V2EjEE= 
$ i= ^g= = 
Se 
TO BE COMPLETELY FILLED IN BEFORE SIGNATURE BY PAYEE, AND THERE 
MUST NOT BE ANY ERASURE OR OTHER ALTERATION WHATEVER, 
7 » ' - <3 
_’—»_day ol 
Received in Cash this 
19X2 , from 
Dollars, in full 
of the above account, which I CERTIFY TO BE CORRECT. 
Do not sign in duplicate. 
(Signature) 
(Title).... 
Witness to signature by mark. 
L4*.. 
(Name,) 
8—2707 
(Address.) 
