. . , b6 é » oa Bye ty @ b7C rp-794 & FEDERAL BUREAU OF INVESTIGATION ’ evi 10-11-2005 PAYMENT REQUEST —_—_—_—_ eee . DRAFT TYPE Request Type: Payment Type: Forfeiture or Drug Related?: |Catalog: C Advance @ Commercial T Yes CW Expense © Confidential I~ No INFORMATION ABOUT THE REQUESTING EMPLOYEE Official Bureau Name: (Last, First, Middle Social Security Number: |Date of Request: PO) oraz Division: Section: Unit: : elephone Numbe File Number: MM PBCRA PB-2 Po 31E-MM-108062 INFORMATION ABOUT THE REQUESTED PAYEE ——— ec Seu or Taxpayer ID Number: Justification: Printer toner cartridge needed for use in case preparation immediately preceding travel tof DETAILS ABOUT THE REQUESTED DRAFT To be completed by Finance Only Catalog: Description: Amount: CL 15575 7] |see attached Ec $90.09 Total: $90.09 | APPROVAL {pi} | Supervisor: 0 ZA/f SAC / ASAC / AO / SAS: "FS 1 | Supply Technician: : p Draft Approval Officer: FATAL Procurement Authority: , OBLIGATION PROCESSING : C7 D Vendor Aumber: Group Number: VA Obligation Number: Follow,Up Date; . Ai 10 8002. ee LC HPRETIO ISBT | Cast Fenter: Squad or RA: PB Pecumeny umber: tee Dratg rye a Af) % ) ) if. Signature of Cashier: Date: : EXPENSE PROCESSING RO; ume Aft Number: Signature of Cashier: Date: Vv { RL ella Py aay . y Received “APR 15 2011 } DRAFT | dle¢mm Oko 2- 2 0 FD-794 (Revised 10-11-2005)- Page 1 of 1 FEDERAL BUREAU OF INVESTIGATION BO HOUSE_OVERSIGHT_021696 |