[104-10163-10176.pdf — page 88]
# SECRETREIMBURSEMENT VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONALNAME OF CLAIMANT: AMBIDDY-1 (Carl R. Jenkins)DESCRIPTION OF EXPENDITURE - ATTACH RECEIPTS AND OTHER SUPPORTING DOCUMENTSReimbursement for operational travel expenses for trip to Central America in August 1965 per attached letter dated 4 Sep 1965 which outlines expenses.AMOUNT: $533.55I CERTIFY THAT THE DISBURSEMENTS ITEMIZED ABOVE WERE NECESSARILY MADE BY ME IN THE CONDUCT OF OFFICIAL BUSINESS OF A CONFIDENTIAL, EXTRAORDINARY, OR EMERGENCY NATURE, THAT I HAVE NOT BEEN, NOR WILL I BE REIMBURSED THEREFOR FROM ANY OTHER SOURCE, AND THAT THIS CLAIM AND ATTACHMENTS ARE TRUE AND CORRECT.I CERTIFY FUNDS ARE AVAILABLEOBLIG. REF. NO. CHARGE FAR ACCOUNT NO.DATE: SIGNATURE OF CLAIMANTDATE: AUTHORIZED SIGNATUREDATE: APPROVEDSIGNATURE OF APPROVING OFFICER: John L. Hart, DCEED/CDATE: CERTIFIED FOR PAYMENT OR CREDITSIGNATURE OF CERTIFYING OFFICERRECEIPT FOR FUNDS RECEIVEDIN THE AMOUNT OF:DATE: SIGNATURE OF PAYEE AGENTSPACE BELOW FOR EXCLUSIVE USE OF OFFICE OF FINANCE| DESCRIPTION-ALL OTHER ACCOUNTS 13-33 | 34-39 STATION CODE | 40. 41        | 42-47 OBLIG. REF. NO. | 48- 50 PAY OR GENERAL LEDGER | 51-54 ACCT. NO. | 55-66 COST FAN ACCOUNT SYMBOL | 61-66 | 67-70 OBJECT CLASS | 71-80 AMOUNT || ------------------------------------ | ------------------ | ------------- | --------------------- | ---------------------------- | --------------- | ----------------------------- | ----- | ------------------ | ------------ || DESCRIPTION: ADVANCE ACCOUNTS 13-27  |                    | XC PO ED NE D | ADVANCE ACCT. NO.     | PER.8 CODE YR                |                 |                               |       |                    |              ||                                      |                    |               |                       |                              |                 |                               |       |                    |              ||                                      |                    |               |                       |                              |                 |                               |       |                    |              ||                                      |                    |               |                       |                              |                 |                               |       |                    |              ||                                      |                    |               |                       |                              |                 |                               |       |                    |              ||                                      |                    |               |                       |                              |                 |                               |       |                    |              ||                                      |                    |               |                       |                              |                 |                               |       |                    |              ||                                      |                    |               |                       |                              |                 |                               |       |                    |              |DATE: PREPARED BYDATE: REVIEWED BYTOTALSFORM 264 OBSOLETE PREVIOUS EDITIONSSECRET