53.301-1165 Standard Form 1165

INTERIM RECEIPT FOR CASH

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

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(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