Public Voucher For Purchases And Services Other Than Personal (Sf-1034)
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1Standard Form 1034
VOUCHER NUMBER
PUBLIC VOUCHER FOR PURCHASES AND
Revised October 1987
Department of the Treasury
SERVICES OTHER THAN PERSONAL
1 TFM 4-2000
U.S. DEPARTMENT, BUREAU, OR ESTABLISHMENT AND LOCATION
DATE VOUCHER PREPARED
SCHEDULE NUMBER
CONTRACT NUMBER AND DATE
PAID BY
REQUISITION NUMBER AND DATE
PAYEE'S
DATE INVOICE RECEIVED
NAME
AND
ADDRESS
DISCOUNT TERMS
PAYEE'S ACCOUNT NUMBER
SHIPPED FROM
TO
WEIGHT
GOVERNMENT B/L NUMBER
DATE OF
ARTICLES OR SERVICES
UNIT PRICE
AMOUNT
NUMBER AND DATE
QUAN-
DELIVERY
(Enter description, item number of contract or Federal supply schedule,
OF ORDER
TITY
PER
COST
(1)
OR SERVICE
and other information deemed necessary)
(Use continuation sheet(s) if necessary)
(Payee must NOT use the space below)
TOTAL
PAYMENT:
APPROVED FOR
EXCHANGE RATE
DIFFERENCES
PROVISIONAL
=$
=$1.00
COMPLETE
BY
2
PARTIAL
FINAL
Amount verified; correct for payment
PROGRESS
(Signature or initials)
TITLE
ADVANCE
Pursuant to authority vested in me, I certify that this voucher is correct and proper for payment.
2
(Date)
(Authorized Certifying Officer)
(Title)
ACCOUNTING CLASSIFICATION
ON (Name of bank)
CHECK NUMBER
ON ACCOUNT OF U.S. TREASURY
CHECK NUMBER
P
A
I
D
3
CASH
DATE
PAYEE
B
$
Y
PER
1. When stated in foreign currency, insert name of currency.
2. If the ability to certify and authority to approve are combined in one person, one signature only is necessary; otherwise the approving
officer will sign in the space provided, over his official title.
3. When a voucher is receipted in the name of a company or corporation, the name of the person writing the company or corporate
TITLE
name, as well as the capacity in which he signs, must appear. For example: "John Doe Company, per John Smith, Secretary", or
"Treasurer", as the case may be.
Previous edition usable
PRIVACY ACT STATEMENT
The information requested on this form is required under the provisions of 31 U.S.C. 82b and 82c, for the purpose of disbursing Federal
money. The information requested is to identify the particular creditor and the amounts to be paid. Failure to furnish this information will
hinder discharge of the payment obligation.
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