[104-10245-10000.pdf — page 114]
SECRET# ACCOUNTING FOR FUNDS| ITEM NO. | DESCRIPTION                                                                                      | FROM (and including) | TO (and including) || -------- | ------------------------------------------------------------------------------------------------ | -------------------- | ------------------ || 1        | FUNDS AND ADVANCES ON HAND BEGINNING OF PERIOD (total of items 3a and 3b of previous accounting) | 4 Sept 64            | 1 Oct-64           || 2        | FUNDS RECEIVED DURING PERIOD                                                                     | DATE 4 Sept 64       | SOURCE 1 Oct 64    || 3        | TOTAL TO BE ACCOUNTED FOR                                                                        |                      | $ 7,998.75         || 4        | FUNDS DISBURSED (itemize on reverse side)                                                        |                      | 7,998.75           || 5        | AMOUNTS ON HAND END OF PERIOD                                                                    |                      | 7,998.75           ||          | A. FUNDS ON HAND                                                                                 |                      |                    ||          | B. OUTSTANDING ADVANCES TO OTHERS (attach schedule if necessary)                                 |                      |                    || 6        | TOTAL ACCOUNTED FOR                                                                              |                      | $ 7,998.75         |I CERTIFY THAT THE DISBURSEMENTS ITEMIZED ON THE REVERSE SIDE HEREOF NECESSARILY MADE BY ME IN THE CONDUCT OF OFFICIAL BUSINESS OF A CONFIDENTIAL NATURE, THAT I HAVE NOT AND WILL I BE REIMBURSED THEREFORE FROM ANY OTHER SOURCE; AND THAT THIS ACCOUNTING, AND ATTACHMENTS ARE TRUE AND CORRECT IN ALL RESPECTS.| DATE          | SIGNATURE OF INDIVIDUAL DISBURSING ACCOUNT || ------------- | ------------------------------------------ || 1 October-64- | Evalena S. Vidal                           || APPROVED      | Theodore G. Shackley                       || RECEIPT                               | 1 October 64                                        | FOR USE OF THE FINANCE OFFICER ONLY |           |              || ------------------------------------- | --------------------------------------------------- | ----------------------------------- | --------- | ------------ || TYPE OF FUNDS                         | AMOUNT ACCEPTED FOR REPLINISHMENT IN THE AMOUNT OF: |                                     |           |              ||                                       | BLOCK NO.                                           | NO. OF UNITS                        | DATE      | DOLLAR VALUE || GENERAL LEDGER ACCOUNT IDENTIFICATION | SUBSIDIARY IDENTIFICATION                           | DOLLAR VALUE                        | POSTED BY |              ||                                       | TOTALS                                              | DEBIT                               | CREDIT    |              |COST ACCT. NO. CLASSIFICATION| REMARKS                                                                      |      |                                                               || ---------------------------------------------------------------------------- | ---- | ------------------------------------------------------------- || AMHUD-3 radio program on WRUL for July, Aug and Sept 1984. Receipt attached. |      |                                                               || VOUCHER NO.                                                                  | DATE | CERTIFIED FOR PAYMENT OR CREDIT AUTHORIZED CERTIFYING OFFICER |SECRET