[104-10245-10000.pdf — page 102]
# SECRET(When Filled In)## ACCOUNTING FOR FUNDS| NO. | ITEM DESCRIPTION                                                                                  | PERIOD FROM (and including) 13 November 64 | PERIOD TO (and including) 1 December 64 || --- | ------------------------------------------------------------------------------------------------- | ------------------------------------------ | --------------------------------------- || 1   | FUNDS AND ADVANCES IN HAND BEGINNING OF PERIOD (total of items 5a anci 5b of prevrnus accounting) |                                            |                                         || 2   | FUNDS RECEIVED DURING PERIOD                                                                      |                                            |                                         ||     | DATE 13-Nov-64                                                                                    | SOURCE JYWAVE                              | $1,000.00                               || 3   | TOTAL TO BE ACCOUNTED FOR                                                                         |                                            | 1,000.00                                || 4   | FUNDS DISBLASED (itemize on reverse side)                                                         |                                            | 1,000.00                                || 5   | AMOUNTS ON HAND END OF PERIOD                                                                     |                                            |                                         ||     | A. FUNDS ON HAND                                                                                  |                                            |                                         ||     | R. OLTSTANDING ADVANCES TO OTHERS (attach schedu'e if necessary):                                 |                                            |                                         || 6   | TOTAL ACCOUNTED FOR                                                                               |                                            | $-1,000.00                              |I CERTIFY THAT THE DISBURSEMENTS ITEVIZED ON THE PETERSE SIDE HERECT FERE NECESSARILY WAOF BY ME IN THE CONDUCT OF OFFICIAL BUSINESS OF A CCAF CENTIAL NATURE, THAT I HAVE NOT BEEN CA BE. REIMBURSED THEPEFOR FRCY ANY OTHER SOURCE AND THAT THIS ACCOUNTING AND ATTACHMENTS ARE TRUE AND CORRECT IN ALL RESPECTS.DATE 1 December 64SIGNATURE OF INDIVIDUAL RENDERING ACCOUNTSvalena S. Vidal OFFICERAPPROVEDDATE 1 Decembeт 64I MERERY LECGE REPLENISHMENTRECEIPT IN THE AMOUNT OFTheodore Gishackley SIGNATUREFOR USE OF THE FINANCE OFFICER ONLY| TYPE OF FUNDS                         | BLOCK NO.                | NO. OF UNITS       | RATE                | DOLLAR VALUE || ------------------------------------- | ------------------------ | ------------------ | ------------------- | ------------ || GENERAL LEDGER ACCOUNT IDENTIFICATION | SOSIDIARY IDENTIFICATION | DOLLAR VALUE DEBIT | DOLLAR VALUE CREDIT | POSTED BY    ||                                       |                          |                    |                     |              ||                                       |                          |                    |                     |              |TOTALSDISTRIBUTION OF EXPENSES| COST ACCI. NO. YODARK/1- | OBLIGATION NO. INCREASE DECREASE | SLB-CAJECI CLASSIFICATION || ------------------------ | -------------------------------- | ------------------------- ||                          |                                  |                           |REMARKS One time payment to AMBUD-1 for hospital bills, etc. Money order recapts attached as well as Postal Dept.receipt of delivery.VOUCHER NO.DATECERTIFIED FOR PAYMENT OR CREDITAUTHORIZED CERTIFYING OFFICERFORM9.63 42 USE PREVIOUS EDITIONS.SECRET(1)