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be ‘, y * b7c FEDERAL BUREAU OF INVES ATION PAYMENT REQUEST Revised 10-11-2005 DRAFT TYPE Forfeiture or Drug Related?: T~ Yes Iw No Request Type: Payment Type: © Advance @ Commercial i Expense © Confidential Social Security Number: Date of Request: 04/07/2011 File Number: 31E-MM-108062 Division: MM INFORMATION ABOUT THE REQUESTED PAYEE Social Security or Taxpayer ID Number: Justification: Printer toner cartridge needed for use in case preparation immediately preceding travel tof Kl DETAILS ABOUT THE REQUESTED DRAFT To be completed by Finance Only Catalog: Item Number: Description: See attached EC Supervisor: SAC / ASAC / AQ / SAS: Supply Technician: Draft Approval Officer: Procurement Authority: OBLIGATION PROCESSING WET) V¢ ER} G Numb Obli au, aie 1 DBO b2 DRT? Cg yi ter, Squad or RA: PB aa ZAGD oh Signature of Cashier: Date: Follow i Date; OTL. “ Tat [LZ EXPENSE PROCESSING ee Aft Number: Signature of Cashier: Date: Y~2e-y U bao PARTy 7 Re Gceived “APR 15 2011 j ) DRAFT , Slemm-\0802- 240 FD-794 (Revised 10-11-2005)- Page 1 of 1 FEDERAL BUREAU OF INVESTIGATION HOUSE_OVERSIGHT_021696