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Appropriation: "Registration and Selection for Mili- Symbol.... $.
tary Service.

Appropriation:

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Symbol.... $.
Symbol.... $.

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.100 Blank St., Any City...

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(Account to be completely filled in by payee, or before signature by payee, without alteration or erasure of any kind.)

I certify that the above account is correct, and that payment therefor has not been received.

amined by

(Do not sign in duplicate.)

Signature of Payce....

(Any notations made in spaces provided therefor on the reverse of this voucher become a part of this

certificate.)

I certify that the above articles have been received by me in good condition, end in the cuality and quantity above specified, or the services performed as stated, and they are in accordance with orders therefor; that the prices charged are reasonable, and in accordance with the agreement, or that they were sccured in accordance with No....... of the method of advertising and under the form of agreement lettered as shown on the reverse hereof.

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*When a voucher is certified in the name of a company or corporation, the name of the person writing the company or corporate name, as well as the capacity in which he sins, must appear. For example: "Chicago Edison Company, per John Smith, Secretary," or Treasurer, as the case may be.

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This is to certify that I have counted the cash and verified the net balance, excepting the depositary balance, as stated on this account current.

I CERTIFY that the above is a full, true, and correct account of all moneys coming into my possession on account of the United States during the period stated. The balance due the United States of $.

With. With..

ON DEPOSIT.

is held as follows:

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(NOTE.-The cash account must be completed by the disbursing officer. If there were no cash transactions during the period for which the account is rendered, that fact must be stated on the face of the cash account.)

Total

WAR DEPARTMENT.

(Bureau or office.)

ACCOUNT CURRENT

OF

(Place.)

Respectfully forwarded to the.

191

U. S. Army, Washington,

D. C., for administrative examination and reference to the Auditor for the War Department.

(Official designation.)

191

191

Office of the

SECOND INDORSEMENT.

WAR DEPARTMENT.

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WASHINGTON, D. C.

191

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U. S. A.

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