Form No. 17 . 
PAY AND COMMUTATION 
II certify that the amount charged in the foregoing account is correct and, just. That during the period charged for I have been regular ly 
statipnejl on duty at. 
Ol , 8 ^. .. ... , by S. 0. No . yfj 
! 2) 
.j ip. <0.pvUcu<e^ / 2. 2 
dated, Headquarters 
<*■< eyU '/ f y /<J ofc a'iscrJJ* cierV £ &. fo.£/j^)j)y r P*7hat I havT not received commutation of 
(/narters, and have not had an assignment, of public quarters at any 
I was last paid to . . .., 190..., by Major . 
to have received this .. day of . . 
U S. A., in full of this account, the sum of .... 
JTo. .. .., on 
No . ., on 
No ... on 
(Signed in Duplicate). 
station, for tire time charged. 
, 190-.- , of Major 
, Paymaster, U. S. A., and acknowledge 
., Paymaster, 
... . ... dollars, by check 
100 
UP n 
*Kor copy of order see voucher No 
, of Paymaster 
, account for 
» 190 .-. 
jcr>oa 
