53.301-1165 Standard Form 1165

F




INTERIM RECEIPT FOR CASH

DATE ---------------------- Received of Impres Fund Cashier $ ----------------------------------------- for which I hold myself accountable to the United States.








-------------------------------
(Signature)




NOTE TO SIGNER

Be sute this receipt is marked "VOID" and returned to you when the transaction is completed or the funds returned to the Cashier.

 

Standard Form 1165
7 GAO 5100
1165-105


RECEIPT FOR CASH –SUBVOUCHER

(To be used when invoice is not available)


Subvoucher No. -----------

DATE -----------------------

 

Received in cash from ------------------------------------------------------------------------------
------------------------------------------------------------- and ------------------ ($-----------------) for the following:

 

QUANTITY

ARTICLES OR SERVICES

 

 

AMOUNT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vendor -----------------------------------


Address ----------------------------------

---------------------------------


By ---------------------------------------------
(Signature of Vendor/ Agent)

Title -------------------------------------------
(DO NOT SIGN IN DUPLICATE)

 

PURPOSE (Project, etc.)

 

APPROPRIATION AND ACCOUNTING CLASSIFICATION