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ring instrunent. ITEM 21 - The Schedule and Voucher Number will be entered by the office which stoat ly schedules the approved amount for payment by the Treasury Department. ITEM 22 - Enter, if appropriate, my data not provided for elsewhere on the receiving report, such as, reasons for any claim amounts disalbwed. EFTA

ent by Din Own Fontaine. EFTA00178447 GENERAL This is a multi-purpose form designed to sene as an Authorization, Purchase Oder, Itemized Invoice, Receiving Report and Payment voucher in conjunction with 'requests for fironcial information," pursuant to theRight toFinancial Privacy Act of 1978, P.L 9S-630, Tide

rdering insetuant ITEM 21 • The Schedule and Voucher Number will be entered by the office which comity schedules the approved amount for pan* em the Treasur. Denaturant ITEM 22 - Es, of appropriate. any data not provickd for elsewhere on the receiving report, such as, reasons fir any claim amounts dna lb

08-80736-CV-MARRA P-000234 EFTA00227614 GENERAL This is a multiputpose form designed to sent man Authorization. Purchase Oder. Itemized Invoice, Receiving Report and Payment voucher en comenceon with 'Fewest for fun gal Mr0111111t, pursuant to the Right *Financial Pnvacy Act of 1971. P L 95-630, Tide XL 12U

ordering instrunent ITEM 21- The Schedule and Voucher Number will be entered by the office which stually schedules the approved amount for moment by the Treasury Department. ITEM 22 Enter, if appropriate, my data not provided for elsewhere on the receiving report,such as, reasons for any claim amounts disallowed. EFTA0

ORM 0110-211 APR. 84 EFTA01660251 • GENERAL This is a multi-purpose form designed to sane as an Authorization, Purchase Oder, Itemized Invoice, Receiving Report and Payment voucher in conjunction with 'requests for financial information, pursuant to the Right toFinancial Privacy Act of 1978, P.L. 95430, Tide