[Model Disbursement and Collection Vouchers]
[From the U.S. Government Publishing Office, www.gpo.gov]
Ta/. 3 S': ,*-s-e7 NON-CIRCULATING
MODEL DISBURSEMENT
AND
COLLECTION VOUCHERS
W A R DEPARTMENT • 1 DECEMBER 19 4 3
NTSU LIBRARY
TM 14-507
C 1
TECHNICAL MANUAL
MODEL DISBURSEMENT AND COLLECTION VOUCHERS
Changes! WAR DEPARTMENT,
No. 1 J Washington 25, D. C., 19 May 1944.
TM 14-507, 1 December 1943, is changed as follows:
Page 9, on Purchase Order and Invoice, delete stamp showing voucher number, amount, and name of disbursing officer.
Page 12, on Invoice, delete stamp showing voucher number, amount, and name of disbursing officer.
Page 13, on Voucher covering partial payment in favor of Square Deal Construction Company, add at top of voucher “C. P. F. F.”
Page 31, on War Department Form No. 336, delete the “Supporting papers” block.
Pages 31 and 37, add certificate as follows:
“I hereby certify that I hold an aeronautical rating as pilot; that during the period for which aviationpay is claimed on this voucher I was, by orders of competent authority, required to participate regularly and frequently in aerial flights; and, in consequence of such orders, I did participate in regular and frequent flights, while in a duty status, sufficient to meet the requirements of Executive Order No. 9195, 7 July 1942 (AR 35-1480).”
Pages 32 and 37, delete Standard Form No. 1051 (Flight Certificate and Schedule).
Page 37, on War Department Form No. 336, in the “Supporting papers” block, delete “Flight Orders” and “Standard Form No. 1051 (Flight Certificate and Schedule).”
Page 65, Index, following “Donation, $10,00 payment, discharged military prisoner” change page number 23 to 26.
[A. G. 300.7 (24 Apr 44).]
By order of the Secretary of War:
G. C. MARSHALL,
Chief of Staff. Official:
J. A. ULIO,
Major General,
The Adjutant General.
Distribution:
As prescribed in paragraph 9a, FM 21-6: Armies (10); Corps (10); SvC (10); T of Opns (10); Depts (10); Base C (10); D (2); B (2); C14 (5).
For explanation of symbols, see FM 21-6.
AGO 174A—580101°—44
U. S. GOVERNMENT PRINTING OFFICE: 1344
■ t
TM 14-507
C 2
TECHNICAL MANUAL
MODEL DISBURSEMENT AND COLLECTION VOUCHERS
Changes
No. 2
WAR DEPARTMENT, Washington 25, D. C., 19 May 1944.
TM 14—507, 1 December 1943, is changed as follows:
Station numbeis will appear on vouchers in compliance with Circular No. 163, War Department 1944.
Remove pages 43, 44, 45, and 46 and substitute revised pages 43, 44, 45, and 46 herewith.
[A. G. 300.7 (27 May 44).]
By order of the Secretary of War;
Official:
G. C. MARSHALL, Chief of Staff.
J. A. ULIO, Major General, The Adjutant General.
Distribution:
As prescribed in paragraph 9a, EM 21-6; Armies (10); Corps (10); Sv C (10); T of Opns (10); Depts (10); Base Comd (10) ;D (2);B (2);C 14 (5).
For explanation of symbols, see FM 21-6.
NTSU LIBRARY
1 Dec 43
TM 14-507
(FASTEN ALONG THIS EDGE)
z 2 hl oaJ O ID
K O 0 6gS bn the pd for
M z S o 5q H men hamed ing thio peri —
o |« Cz III Sgf Ty that the ehliste lies of| APO 765 dur jllotmejnt is plaime LulAsI 6.60 1 — 0 £4 o CU co co 5 Jul/43 3.45 ju^«3 | Jul/43 20.00 1 8 g LO CO on May I •ies of GPLD 5h Inf
NAMES. PRESENT AND ABSENT BY GRADE AND COMPONENT (Names of dependents and, where applicable, determination of dependency to be noted as “Attached’- or “Filed with Voucher No. .”) Unless otherwise states pithin nav roll were in t jwhich pay and/or reimburs REGULAR ARM? | FIRST SERGEANT KcKay, Arthur F. SERGEANTS © o p. £ o w ci Aptd sgt fr cpl effe |19/43 par 2 SO 136 Hq 15C |Jun 19/43 not shown on pr |Cook, John J# Aptd cpl fr pvt effe |19/43 par 2 SO 136 Hq IfiC (Jun 19/43* Aptd sgt fr cp pun 26/43 par 2 SO 139 Hq § s o b £ 60 CD CM 5 s OTHER COuPGNElTS SERGEANTS White, Thomas W. Class E almt $25 ps indef period fr Apr/41 oq 30/43 disoontd liar 31/43 CDB herewith. Due EM $75 | for Apr, May & Jun/43* | CORPORALS 1 Bvans, Donald E* Due EM FSPA on $30 [ od on prior P/?. PRIVATES 'talker, Thomas C. | last pd to inol Apr t fej John F» Doe FD.Left Uf J6/43«Arrvd within boundah IPO 755 Jun 16/43. Due US| >4.32. Due Co Fd Co M 150N IPO 755, $3.50. !
ooiA-tes sieaA jo aeqamN UJ to CM H CM r4
g Z CO 04 CO Oct 21/40 5 CO Jun 15/40 7 oo o Feb 1/40 10 O1 co «D Got 14/40 1 IS fr- 00 o 04 Jan 19/41 21 | 04 CM CO 04 May 6/41 24 | 04 co 04 04
(30Q3 sihi pNoiy. jtgjsyj)
43
19 May 44
TM 14-507
C 2
<3003 SIHX OHO1S N3J.SV3)
44
19 May 44
TM 14-507
C 2
For Use of Finance Department Only
(at)«a siHi OHOir
(FASTEN ALONG THIS EDGE)
45
1 Dec 43
TM 14-507
C 2
PAY ROLL
(30Q3 SIH1 0N03V N3XSYJ)
46
592093° U. S. GOVERNMENT PRINTING OFFICE : 1944
NToJ L\BSARYi
TM 14-507
C 3
TECHNICAL MANUAL
MODEL DISBURSEMENT AND COLLECTION VOUCHERS
Changes} WAR DEPARTMENT,
No. 3 J Washington 25, D. C., 21 August 1944.
TM 14-507, 1 December 1943, is changed as follows:
Page 6, change“1 day at $5.00 per day—$5.00” toread“%dayat$5.00perday—$3.75.” Change total of voucher in all places to $22.07.
Page 10, change phrase “Service Command Finance Officer” in notes to read “Service Command Fiscal Director.”
Page 29, items (16) and (17), delete “Certificate on reverse made a part hereof.” Item (17), delete signature and add “See par. 19, AR 35-4220.” Delete certificates relative to items (16) and (17).
Page 33, delete certificate relative to rental allowance.
Page 34, item (17), delete “Certificate on reverse made a part hereof”, and signature, and add “ See par. 19, AR 35-4220.” Delete certificate relative to rental allowance.
Page 35, on voucher in favor of Vienie L. Young, add note “Supporting papers: Quarters Assignment.”
Page 35, on voucher in favor of Harold E. Clark, in item 17, delete “Certificate on reverse made a part hereof”, and signature and add “See par. 19, AR 35-4220.”
Page 36, in certificate relative to item (16), paragraph 3, change date “June 30, 1943” to “July 31, 1943.” Paragraphs 4 and 5, change dates “July 1, 1942 to June 30, 1943” to “August 1, 1942 to July 31,1943.” Delete certificate relative to item (17).
Page 36, on voucher in favor of Mildred J. Black, add on face of voucher “S/S filed w/Vou. # 15,096 May 1943 accts of Major Walter Cory F. D.”
Pages 54 and 55, delete War Department Form No. 373.
Pages 61 and 62, W. D., M. D. Forms Nos. 27 and 28, in lower left corner change “By order of The Surgeon General:” to “For the Commanding General.” Change “Washington, D. C.” to “Fort Finance, D. C.”
Page 63, insert “July 4/43” in lower right corner before “RECEIVED FROM.”
Add page 2A.
Remove pages 27 and 28 and substitute revised pages 27 and 28 herewith.
Remove pages 31 and 32 and substitute revised pages 31 and 32 herewith.
All disbursement and collection vouchers will reflect the station number of the disbursing officer as prescribed in TM 14-500.
Disbursement and collection vouchers will no longer reflect the appropriation title.
[A. G. 300.7 (5 Sep 44).]
By order of the Secretary of War:
G. C. MARSHALL, Official: Chiej of Staff.
J. A. ULIO,
Major General,
The Adjutant General.
Distribution:
As prescribed in paragraph 9a, FM 21-6; plus, Armies (10); Corps (10); Sv C (10); T of Opns (10); Depts (10); Base C (10); D (2); B (2); C 14 (5).
For explanation of symbols, see FM 21-6.
616297°—44
TM 14-507
C 3
21 Aug 44
2A
21 Aug 1944
TM 14-507
C 3
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PAID BY
Walter Cory, Major, F.D.
Ft. Finance, D.C, Syn #210500 3ta #1500
July 44
(For use of paying office)
.....Cal anal,-GAG___________.01949.....
(Rank and organization) (Serial No.)
__________________________________________________ Station No........._......... . On duty at present station per Par. ._1.., S. O. No. .163.._, Hdqrs.WD..........___________JulX-X..., 19.44.
Departed frornFt^Brag^yN^G^..J.ul -3 -« 1944- Reported for duty atFt<. FinanceJnl 6..19-44-
DEPENDENTS: .
(3) Lawful wife ..-Mrj3^..D©r.Qthy-.I a i! ! j hi
** • © fc. I^5i Is =®
3 ■§ g? i m S gi" | J g o <3 8£§ “JU £ 2§S]
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1 Dec 43
26
1 Dec 43
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TM 14-507
1 Dec 43
1
28
1 Dec 43
TM 14-507
571398°—44----5
29
TM 14-507
1 Dec 43
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30
1 Dec 43
TM 14-507
Hie 4*
31
TM 14-507
1 Dec 43
I
32
1 Dec 43
TM 14-507
33
TM 14-507
1 Dec 43
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1 Dec 43
TM 14-507
35
TM 14-507
1 Dec 43
36
1 Dec 43
TM 14-507
571398’—44---6
37
TM 14-507
1 Dec 43
38
1 Dec 43
TM 14-507
39
TM 14-507
1 Dec 43
(FASTEN ALONG THIS EDOE)
l«L s 8 «- 8
ii W s cv iO .ra^per 1 | q/uav sv 5677654 1 a n c\ nJ g c •a A 2 Indctd.Jul 7/43. Pai da te nf indrtn Cl H al mt per mo fr Jul 1/43 to ind Lfirst- cranium remit.tad d Brown. William (10) Sk AB 35-1440 fr Jul ta Jul 9/43 Inal. 1 j
| Toaqra^N «o w H w o c o
fcE?S 1 Si! ? w y y S' o L 04 W & 2 »- is o 8 04 3s s a *■>04 X
(3003 8IH1 OHOOY K318YJ)
40
1 Dec 43
TM 14-507
(3003 SIHX OKO1Y N31SYJ)
(3003 SIHX OKOOY N3XSYJ)
41
TM 14-507
1 Dec 43
&
For Uss of
(1003 SIHX OHOTY N3XSYA)
(FASTEN *LOM« THIS EDOE)
42
1 Dec 43
TM 14-507
(FASTEN ALONG THIS EDOE)
<3003 SIH1 ONOTY N31SYJ)
FOREIGN DOTY
PAY ROLL
43
TM 14-507
1 Dec 43
(3003 SIHX ONO1Y N3XSYX)
(3003 SIHX OHO1Y N3XSYJ)
44
1 Dec 43
TM 14-507
Use of Finance Department Only
(FASTEN ALOXO THIS EDOE)
45
TM 14-507
1 Dec 43
EM ALONG THIS EDOE)
I M « 1 ■5 1 8 r4 Jul 20) 1.50 / 3.00
If 0 1 •d ® *< T* •a-s Is * “S K g K
p "® a 8 • c s Q / J E c >*
le perl d with c J S % tc 24/43. Iduty fr 1 3028467 by Capt I is cpl fr ra j° |8£T OS »0 h E td | R 3982522 J Iby Major 1 “LD $8.50.
NAMES. PRESENT AND ABSENT BY GRADE AND COMPONENT (Nin» of dependents and, where applicable, determination of dependency to be noted as “Attached" or "Fited with Voucher No. I certify that, duri men carried on this nav have not been in a flyin .ajLJsantaZfl. .sf n_Mxachud p .5? £ g £ is Is rating and have been en^ as parachute duty 1 i FIRST SERGEANT Green. Willard C. SM. Due EM add pay fd duty fr July 1 to 31/43 11 | n 3 I g t 1 <4 1 8 Abrahaa. Arthur A. 1 AWL July 3 to 5/43 1 be conf 3 me a. and to fori mo for a like period per |3 Serv 0 July 5/43. UneJ portion sent remitted Juj ner GCMO 64 3 Serv C July Due Hi add pay for prcht j July 1 to 31/43 IncL i !Babcock. John Ta I Last pd to May 31/43 'Richard E. Roe FD. Trfd d cpl 139th Inf Ft Benning 1 Jirne 12/43 0 recd at eta June 12/43. IXie IM add J prcht duty fr June 18 to1 incl. Due US part pat I White. Danald D. 1 Last pd to May 31/43] Walter Cory TO. Du. US Ga AWOL June S to 29/43 inc^
KfUNUW/ jo 4*qtnnx at CQ CM 9
ft 5M« CM co ** •0 <0 Oct 14/41 oo o> 0 Nov 16/41 1 11 CM CO «e Mb T»/e Ar t- CO o g CM zz co CM s »o CM 8
<3003 9IHA OKOTY M31SY1)
46
1 Dec 43
TM 14-507
(3O«a 91HX DUO IV HUSYJ)
<10*1 USX OHO1Y H3XSYJ)
47
TM 14-507
1 Dec 43
For Use of Finance Department Only
48
1 Dec 43
TM 14-507
(FASTEN ALONG THIS EDGE)
(3OG3 SIHJ. ONOTY N31SYJ)
49
TM 14-507
1 Dec 43
(
Yfalter Cory
ORIGINAL F,D’ <™,,.FOLO ro" ™* risaaea omas
FINAL STATEMENT of 59th Inf» Svm #210500* D’<’buch" No-
(Namatfeaidtar) (Serial No.) (Raak) (Company) * "(^WWent)"....... ................
Accepted for enlistment at „“® •________________________ Enlisted <*■> 0o vOfr®!* 10_____ _____,19*2..,., ................................
DisohArred (Soo tartmotton 8) ...........' 1943 THE UNITED STATES
-----------------------------------at........Ft....Fin*ncei.D.C.. on .... July..26 .............19.4?.. To____________aflhfir.t..Ix..Elll9Wl............
(Name trf ooidJer)
... Pr.Q..Cfi..A...3.9th..inxjintry.......
(Rank) (OrgBQiiAtioa trum which dteehM^d)
.IIAR615-.36O)t.4th..Ind Ltr.3rd Sery C Jul 23/43, Having over._____Q.
Dvb Soldibb for..
For additional pay.....
For clothing-..........
For deposits—E.Qr.tafe. _______________________________
(A* pw Itosntnod list on outer fold) 'Words)
For pay detained by court-martial ............Ifothih&
(Ifa loatrualco u; -----
For...................................
__years service at data of..
Nothing *
Nothing
....^ IWort.) .......
19.1?.
Insurance, Claw ....... I.
Allotment, Class ...... $.
DUE SOLDIER Pay, 19 (prior fiscal year).
and-----dollars (3________
and oo 4 oil a ra (i_.AO*po 100
--------------- And dollars ($........... (Wards)-joo
......-Nothing.............................
Pay, 19 ;
Interest................:
Allow, in lieu ore......;
Auth..l-74..F..41feQl.
Total pay of Army, 19
4I.2i
43
Last paid to include —T.tlUM..3Q...................., 19..4SI, by_.lfeiPX..Yfe.l-tft.r..Cpxya...FjiPt...........
Due United States ..30 ^89^°
, (Su lastraeUoos 7 and 13)
.......to.J.41Z..?/k3..1n?L-...Nqt .4*.djjcted. on.j>XjLor.ro.Hs,...............................
Auth _.l-B2.P...4ia-14...........
•owsifc -Jraml..nay.............
Auth. J.-5QQO..P..A31rQ2„.....
Travel pay .....................
«n»21^Z4Q425..FaSaaA._42=44
Deposits, Deposit Fund .P.A.U.fZieB...
Auth ..IrvlOB-.F.-AJOr 13.....
1
5T
44
.36.
w 40
IT oo
Remarks: /4VQL_Ji^„3p_.to .July _2/43_ inoX»..„^titl6d _to trayel^gsiyi (Sw InstrucUoaf, especially 10 and IS)
... 218950.6
214330 .212/40425 1-74 P 414-01
_____Total amount due soldier. DUE UNITED STATES For .ieauissh________s........ao
For ..GELD.
Total stoppages...
Balance due soldier
»._jAatt
»..i»aa
129
.49.
...18.
.7,5..
.7.4.
Paid by check No.
States, dated......
19.
on Treasure* United
Deposit with my new account.
----------------------------------------------------------------------------
- v.......................................................................................
I certify that the foregoing Final Statement is correct. I further certify that the payment ______________
to the enlisted man named on the within voucher is not prohibited by any provisionn
(oSWiftJfc the availability of the approprifrt-i"" deceived.
~ uro of Boidiofj
Poet Exchange paid by Check No.............
Treasurer United States, dated fort...............
(To be completely ailed in before ligneture by payee ’ or erasure ’.fcereettor)
IICVCI red----.J.uly_.26............
-----on 19.--
WAR DBPARTM1NT
C*Et»x.39th..Inf,
Tlnout alteration
____,.r 19.4.5., of
Finance Department, U. S. A. ........
T—“.jP. Ind dollars in cash.
Personnel Officer
($110.74)
(SOQ3 SIHX OKOTY H3XBYJ)
50
1 Dec 43
TM 14-507
FINAL STATEMENT
OF
Elliott Robert T.
itaSkaikMi)*..................(Firn
Pfc Co A 39th Inf.
.........(Comjiny)...........('Regiment)...
(To bo filled In by the orgsnliatlon commander)
For value received, transferred to
(Nam. of assignee)'
(Soidiar’i’.lgnaturej.............
Transfer witnessed and noted on discharge.
(See 1 Mtnict'loD •)"
INSTRUCTIONS
1. Final atatement will be riven a. foDowv.—Final roperiy certified to by his immediate commander. wilt ha
’d^bim^Tb7^n« discharge certificate of every discharged soldier except when the final statement has been trait3fWr,\i
onTv m of dificbftree will be tarnished
only tn case of an enlisted man who is discharged from .... i* nfnnHt on* BVB;lobl? D° officer provided with funds to make
payment on final statements. In these cases the officer whn n-TL;, ii 0D® WMk t*,or® th^dlx±2r®rKkS
*“?£• b7 .tnail t0 tbo finance officer who is to mv the luw/tnr . °MeoTlMt mv^nttn thUiluft2b,r*!ink*n bto 0WD bAcd writing, the aaw of last payment to the soldier, and bis credits and debits both in
r,vlre,tta“Mto>««<£rbuigS;t1S, tot”;
uJmS (6«e a“ k win* “■ “*1“ te •“*«
Blank forms for this notification will be supplied br The Ad Intent tot°Sd^ ..Tbe ‘he iSSXJ?wttl
for paymentf lh* OCBt on 01 lbe finance officer to whom he shall apply Jn.^.n’,WUy Of cTr‘,r’dn< officer.—Officers signing and certf-tying to tbe correctness of final statements will be held rmtmrShutJ-fallal *nS nSJisVSuiX
Jis SrLi?*P^5s.b e overpayment on erroneous final atate-
‘|? "‘“Od lh« amounts overpaid U it is found impracticable to make collection from tbe party overpaid
INSTRUCTIONS—Continued
—?l.1_^-I*B3®®^Bnc*Bz—Enlisted men of tbe regular Artur when ‘ravel allowances upon discharge from active service ar. entitled to snme from place of discharge to place of acceptance for enlist-p,¥* Bt Wb?h Of actui
enlistment, If differont from tbe place of acceptance, will In no cose be considered in determining the travel allowances due. *
lUor,Bl J^T-r-In the space for additional pay notation will be hhe bBy.duo 80,d,cr ,or dwtinguiabed service awards, for special qualification in tbe use of arms, etc. ’pccias
•toPP*K«*-—Under tbo beading "Due United
*U, h* al* stoppages for lass of or damage to
nro^7h?^ ,,^0pe^y.?^?^p ‘M,'. ,thJ? S' oppagcs being made under tbe proper bead ngs, o g„ "Clothing.’’ "0 & E,v’ "RS,” "Transportation ” nl d^n,™Or\hto fln.V will be recognlted only wheu
<>«®argc from active service, in writing, indorsed on tbe oflSrto^b? lhBB®,.dier- “nd witnessed by a commlastooed
ThTLSLw?. ilh .1eP“*aW® Person known to tbo finance officer. orSroJl?^'n* l?#.trBnBfat must ,ndor« on lbf dbcharge tbe thM0«nth Of t ie 8‘“leracn‘( and on the Coal statement the fact that such indorsement has been made on tbo discharge.
J?V^.h*rge J’y PttfPhM^—The final statement of n soldier dis-Sth?trKmd I’urcbu3<’ wlu 5how ‘ho amount of purchase price and a full rendered In each previous ffiment.for-Jn^n? by honorable discharge since last discharge by purchase, giving a ^aue5C?KnH8tPJnt Bnd discharge, and reasons fbrS dffiw A soldier discharged by purchase is not entitled to travel pay " listcdS^^h^hlJnAf^J^M^™ fi”?1 statements an> given an en-tr.1., .mBn w.“? ““ not been paid since return from desertion hi. (uvrnint
r c, 7.2? . f. aeP“lw,y. i“® amounts due the soldier and tbe
United States at date of desertion as distinguished from those accruing or incurred after return to military control, together with a wrnrf transcript of the order publishing th* «?ii/m _____-
( . . . ‘■r13 tuo r8S® R aeceasod soldier, final state-
ment and duplicate inventories of effects will be prepared and forwardwt
10 ’V «’-"•?W,“,.STtaS!
£* XSfS4 u°d" "D'“ 8<’ldl"’ »"Du« “• st»S” o!
.J2- Before delivering final statement upon which detxeiti are credited the officer signing it will ascertain whether the soldier has the denoeif book; and, if so. instruct him to present it to the finkn7l M
"S' T‘ i'1E S’«®S-
“’“I*
other miw-nndiwt- whii i A luivui^mie use oi Drugs or liquors or t V-uj menL a,boilld be entered on the final statement under
«X>5 “JWrirsss 5,8? 11
INSTRUCTIONS—Continued
facts and the period! of such ebaenccr should be also entered on the final
rnky^der^tem^ks^11111 D*“ 8UUb'" ^‘fon to tbltr
, : .‘ io Bvntencn ci court-martial win be de-
hf *5® Government until the soldier is discharged from active °rt.rulbed' wb*cb ‘*me tfi® total amount detstned if not forfeited, will be noted on the final statement in tbe spoce provided there-5iffmjnsSi for «• it pertains to thta allowance.
.h subvoueber to Inc final statement. Tbe payment will be ^d* ”p tb® firial statement as. in thu case, Form 309 ts simply a sup-
ORIGINAL
FINAL STATEMENT of ...Thomas.A, .Pear.cn...374(584a.Pvt (AITSl C« B, 32tb Inf , induction „ _ . (Name of soldiar) (Sarl*diM3« ‘
Accepted for wmesaast at .Ilev.QrleanB, Lr, <»•«<««“>
.....■8^s^~....................
------years service at date of ..®i»ChWgs ...Ffl.thlng............................
...........Ja thing
....(8m Inst
....?Q.thin^.......
(Words)
Having over
Due Soldier for__
For additional pay
F°r Cl°thing...............-............................ — »nd __ dollars (».
......................................“‘Idollars (X.
For PS±Mt’7 '
.Qftvt.AteX..QBe..andJK/100.dpl.lwB*.l^r“Mj“.’.....................
(See Instructions 7 and 13)
.2.15215
Remarks:
Bo..tki5e.lP.st.]mAeF..AW..l.Q7t....NQt..«ritltl.sd..to. travel najr,
(See Instructions, especially 10 and 13)
oY-T
.Withheld..ML.wai ____
(Words) ]qq
For deposite.Eittean.w w w and ftf) dollars (1 15.00
(Al per Item* tad list on outer fold) (Words) * '* a°U&r8 kl-A2a.\A<.
For Pi£,'2±i?eu>by court-m&rtil1 -Nothing...... and____dollars (»... .
(fee IMrectta l<> (W“<1*> l» ....
**“’MS.inauaiMOiw !□ ii«qmnm, »u4’w7n.'»44 «)*'”
DUE SOLDIER
--)
-)
-)
Pay. 1® (prior fiscal year)........
Pay, 1« S 50.38-
Interest.............. fi.........
Allow, in lieu ore......fi. .
Auth i-74 F„4i4roi.--.........
Total pay of Army, 19 ......
50 38
-.Interext....1 ST
Auth ..1-82,1.418414.....
dfonw»>1 ?//,n4?5-F..S.-A-424 Z32 JT
Last paid to include.. JuneJO...... 19.43 by...Major Walter.Cory^F.B,
Dtnt United States for...G£LD-Thrfift.and.27ZLQQ.daLUr.e £t3^Z7^TGoyt*Idry
......®»^-50ZlQQ..^^ ____7.
Trave! pay.............................
—* Auth ..............................
21X8910 Deposits, Deposit Fund P.A.D, F/jli — Auth 1-1Q0L. p. 410-13................
Total amount due soldier..........
.218930.6
Remarks: .No..tiae..lOAt..lKl* statement.-The transfer by an enlisted man
rriting, Indorsed on the rssed by a ^commissioned
(Soo Instruction 8)
J purcnaso price and a full
hwOh^n«MKiM!i rpndcre<1 ,'u e^ch previous enlistment terminated by honorable discharge since last discharge by purchase giving xa™t| conviction; or. wnno in confinement under the h0^( ?»*^aAL’,n<'nJ sbouhl l»e entered on the final st itemcnt under Remurks substanti .lly ns follows: "Held to service to tick 2uJd"a RV b| un *1’1 xv » ACt ’ ‘t° 10/15 Ond Nov- 6 ,0 *2/*5;
107 from Jan 6 to 20/18, tacl.ilncon-flncSrnt °«?*Ft* rn1n',,rt^d. AW 107, from Feb. 2 to (1/10; In con-o’/in^ S .V 8 tri.ul 2nd *!rvl"iI wntenco, AW 1U7, from M.ir 10 to abren« '“W'?'' ot L’uy •b»n« without irere
or aoaence sick, not Io lino of duty under AR 80-1410 and aw in?
10 w,“c00,000j000^
(Name) (Serial number)
Pvt.____________ ____Infantry
(Organisation) (Regiment) ......... (StaUonT
who died or whose death is presumed to have occurred in accordance with a finding by the Secretary of War on — 2..Au£u3t.............t19.43...., at foreign..Serviced whose monthly pay on such date for over ...2_
years of service, including additional pay for .f'.or.Ser ,20f Was $ 60,00
”• •* Dollars Onta
Amount of 6 months’ death gratuity pay| 360 I OtT
The following affidavit will be executed only by (1) the widow, or (2) the unmarried child or children under 21 years of age, or (3) the father, mother, brother, or sister if designated as beneficiaries.
AU other designated dependent beneficiaries and unmarried dependent children over 21 years of age, whether or not designated, will execute the affidavit on the reverse of this form.
•Note—If widow subscribes, strike out lines (a), (6), and (c).
If unmarried children under 21 years subscribe, strike out line (b).
If father, mother, brother, or sister subscribes, no part of affidavit should be stricken out.
I (we) do solemnly swear that I am (we are) the * lawful widow ..................................
of the above-named decedent; (siate «i«u)
(a) that there was no widow or other unmarried children under 21 years of age;
(b) or unmarried dependent children over 21 years of age;
(c) living at the time of the decedent’s death; that lam (we are) entitled to receive the 6 months’ death gratuity pay; and that payment thereof has not been received.
(Signature by mark must be witnessed by two witnesses with address of each)
(Signature of witness to payee’s signature by mark)
SIGN ORIGINAL ONLY
Address__________________________________
HELEN R. •' ■«"’>
Address____________________
Address---------------------------------- Address______________________________________________
We, being duly sworn, say that we are personally well acquainted with the above-named payee (s); that we have read the statements made by said payee (s); and that said statements are true to the best of our knowledge and belief.
(Signature by mark must be witnessed by two witnesses with address of each)
Address.......................
SIGN ORIGINAL ONLY
Address 13th St,, Baltimore, McU
(Signature of corroborating witness)
Address............................................. Address x37 Perry Ave..Baltimore, Md?Z
Subscribed and sworn to before me by payee (s) and corroborating witnesses at _Baltimore —.........Maryland.___, this__________________.28........ day of August ............ "43"
[SEAL] SIGN ^^k****/****____________________________________
ORIGINAL (
My commission expires June 30, 194? ONLY_______________Notary Public______________________
______ ______________________________________* ___________ (Official designation)
ADMINISTRATIVE CERTIFICATE =====
I certify that the above-named payee (s), if other than Widow or unmarried child or children, has (have) been designated as beneficiary or beneficiaries by_pvt* Jonn M* 0°*___________________________, decedent;
that the designation described in this voucher is correct as shown by the records of this office; that the payee (s)' named is (are) authorized to receive the 6 months’ gratuity pay on account of the death of the decedent; and that payment thereof is approved in the sum of $_3°2.?.99._______
SiCN _______________________________________________
Date---------------------------------, 19____ original (siw.uu.)
ONLY________________________________________________
(Till.)__________
Paid by check(s) drawn on Treasurer of the United States in favor of Amount(s), $
Check No(s). ___________________
payee (s) named above Date 19______________________________________________________________________
(TO BE CONTINUED ON REVERSE SIDE, FOR OTHER DEPENDENT RELATIVES ONLY) ■•-ami
56
3
1 Dec 43
TM 14-507
The following affidavit will be executed only by (1) unmarried dependent children over 21 years of age or (2) previously designated dependent relatives other than father, mother, brother, or sister. Regardless of age or dependency, married children are not entitled to pay.
•Note, if unmarried dependent child, or children over 21 years of age, subscribes strike out line (bl
HnPorenart thodeoSf8nhateld| i‘'pe,ndet't relatives. other than father, mother, brother, or sister, subscribe to the affidavit, no part thereof should be stricken out, except die word ’•other” under (a).
of
I (we) do solemnly swear that I am (we are) the*_dependent. .lyicle
the above-named decedent; 'bUi
(a) that there was no widow or other unmarried dependent children;
(6) or previously designated father, mother, brother, or sister;
(c) living at the time of the decedent’s death; that I am (we are) entitled to received the 6 months’ death gratuity pay; and that payment thereof has not been received.
1. Married or single? Married........................ <> A , 52
3. Occupation? Lne^ployea (ill health]
4. Income from all sources? ..i7.5^.0Q. a juonth
(Average amount per month)
5. Value of all property owned by you? ..S.UQQ.,00.............. 6. Value of al) property owned by yQUr hus.
band or wife?......none.............. 7. Ago of your husband or wife? . 57.
8. Occupation of your husband or wife? housewife 9 Income of your husband or wife? none ..........................
10. Amount of all contributions of any kind made to your support by the above-named decedent for at least 1 year immediately prior to his or her death? Approximate average per month, $.59,00
11. Were you receiving from any other source contributions of any kind to your support at or near the time of the death of the above-named decedent? ...none if answer is “Yes," state approximate average per month $.............:...............
12. Any other facts tending to show your dependency? ....J.QhflL.IlP.e.s.>....j)ar^nts were killed in an _automqpile accident when he was seven wars old. . Ly wife, and 1 took him to ..
r_aise, ,Ve provided a home, for him and furnished, him.with..clatbes and sent, him high school. He made his home with us until he enlisted in the Army in
J.237.................................
(Signature by mark must be witnesacd by two witnesses with address of each)
SIGN ORIGINAL ONLY
JOHN Address.Dawson,. .Texas.
(Signature of witness to payee's signature by mark)
Address........................................
Address........................
(Signature of payee)
Address___________________________
We, being duly sworn, say that we are personally well acquainted with the above-named payee(s); that we have read the statements made by said payee (s); and that said statements are true to the best of our knowledge and belief.
(Signature by mark must be witnessed by two witnesses with address of each)
Address___________________
(Signature of witness to signature by mark)
Address .....................................
SIGN ORIGINAL ONLY
.......................................................
(Signature of corroborating witness) "
Address ......................
(Signature of corroborating witness)
Address_______Dawson, Texas
Subscribed and sworn to before me by payee(s) and corroborating witnesses at Dawson
---------Texas--------------, this —28------day of ..August_______________, 19 43
[SEAL]
SIGN ORIGINAL
My commission expires
[4
{ (Name)
Notary Public
’ (Official designation)
10—2I479-1
57
TM 14-507
1 Dec 43
WAR DEPARTMENT
Finance Department Form Ng. 19 Aulbciind June 10,1*21
Coll. You. No. 12
Bwted Mm. 2,10%
SOLDIERS’ DEPOSITS
Fort Finance, D. C,
(Enter date ot deposit here)-----
The Chief or Finance, Washington, D. C.
The following deposits have this day been made with _ Wq^erjory^ Finance Department----
’ Sym. No. 210500
Finance Officer, U. S. Army.
NAME (Enter swrspital St. Lov.iSj Missouri (Location)
FOR NURSING ATTENDANCE RENDERED TO—
Sgt., Itry "A" 35th 1'A
At
8TMBOL
Period or Service
From- 19 ^3
July. .2
Jy>iy..5
Jl ly 1< 43
(For use of paying office)
(Rank, Co., and Regt., or Corps, etc.)
Disease or disability ....Appendicitis,, acute..............................
Hours Servet
nights
Dollars
Notations
(Payee must not use this space)
llsCO Pil to'VrOC’AM
.3.
■6.00
18
00
I certify that the above account is correct; that! W^d tbeservice as stated: total
^that I am notreiated to
°"XAL ............V iy..ScnigLr?i. JO................. Nur,r.
I certify that the services of a nurse were indispensable to the proper care of the above-named patient; that the nurse was competent; that the services were rendered as claimed; and that the chargee do not exceed those customary in this vicinity for competent nurses.
uOT’.l W. tt’XIS _____________
SIGN ORIGINAL ONLY
........... M. D., Attending physician.
18
00
r«. HigM
Bureau, or Establishment,
RELAT1$D CLAIi’StCarl A. Wetmore, : >100 JO; '.are County lies;'it al, $82.00
Differences ....
3es to be obtained by
T0Ti-7Pd--by-,-are-fcr-th and..a-.e..cnaru£^tj,£..ii2..
ufflcient to cov-r the
(Signature or initials).....
I certify that the above account is correct: that the patient named therein was .—...............,Qn..duty ................. ..................
F (See Instructions)
...........................................................at the time and place specified; and that care in an Army hospital or by a properly qualified attendant of the Medical Department could not be obtained because........................................................................
18,00.
Approved for ..........
5y ord^r of The Surjeon General:
Date....Jl>ly...7.,..1^3....
Place...... ifeahixigtorta-Sa-C,
SIGN ORIGINAL ONLY
... ... , U. S. Army.
Colonel, lied. Cprns, Surgeon
U. S. Army.
Paid by check no......
favor of payee named above.
.... dated ...J"!?..?.
on Treasurer of the United States in
_____ for $....1§....00. .
62
1 Dec 43
TM 14-507
Section V
WAR DEPARTMENT, QUARTERMASTER CORPS FORMS
REPORT OF SALES made during... .&lX1L..19.4g at_________________________Fo.r.t.JlBbens.e....5«.C«_______________________
By John T. Short. Coot., Q|-:c ales Officer PeriodJuly 1. 1943 to July 4, 1943
SECTIONS SUhSIS.’E/UE EX-A-- HOLES C & E CVxEHEAD
Charge sales last report July 1 2 3 4 Total to date $ 471.60 373.93 383.50 381.20 $1,610.23 $ 10.00 1.26 $ 11.26
xRation credits oft r- a _i Charge sale collections £ w Delinquent accounts = e> 25 T q Total reductions
. Balance to next report $1,610.23 $ 11.26
Cash sales July 1 2 3 4 Charge sales collections $ 93.40 68.40 22.40 30.30 $ 20.00 $ 58.90 $ 5.03
Total for deposit $' 214.50 $ 20.00 $ 58.90 $ 5.03
o z Ration credits £ o Delinquent accounts o 2 < Accum. cr. last report
Accumulated credit FOR Julv 19 43 1 214.50 $ 20.00 $ 58.90 $ 5.03
PROCUREMENT AUTHORITIES OR APPROPRIATIONS TO 7-C-161 A 214/50504 BS&TA 1944-45 7-C-167 A 214/50504 do 215230 M.H. Overhead Total July 4, 1943 Z/JOHH T. SHORT. BE CREDITED $234.50 58.90 5.03 $298.43 !apt.r QMC RECEIVED FROM John T. Short, Capt., CMC Sales Officer In cash and/or checks s 298,43... WHICH TOGETHER WITH PROCUREMENT AUTHORITY OF APPROPRIATION CREDITS FOR SUMS PREVIOUSLY RECEIPTED FOR AS SHOWN HEREON WILL APPEAR ON MY .ACCOUNT CURRENT FOR THE MONTH OF .‘r«lZ...1.943. you. No I?.. WALTER CORY, l-Cior..F,D.......
DATE WAJR DEPARTMENT Q. M. C Form No. 389 Approved August 6, 1900 * V . SALES OFFICER MC i >»«» |0—3IM9-1 FINANCE OFFICER NTH July.. 1943 vou. No. ...23. (Seles officer’s month and voucher number)
63
1 Dec 43
TM 14-507
INDEX
Page
Aide-de-camp with increase for longevity_________ 30
Assignment of claims, payment for supplies_______ 11
Chief Warrant Officer, newly appointed___________ 34
Civilian:
Hospitals, care and treatment________________ 61
Nursing attendance___________________________ 62
Stenographic court reporter__________________ 25
Witness for a court-martial__________________ 39
Civilian employee:
Statement of travel by motor vehicle________ 7
Transportation furnished, per diem____________ 5
Travel by privately owned conveyance, per diem_________________•________________________ 6
Class A pay reservation, refund__________________ 18
Collections:
Field rations furnished officer______________ 33
Sale of salvage or unserviceable property___ 22
Sales of services____________________________ 17
Sales of supplies other than Quartermaster__ 22
Soldiers’ deposits__________________________ .58
Telephone service, unofficial________________ 17
Collector of internal revenue, tax on unofficial telephone calls___________________________________ 15
Contract, CPFF, reimbursement of expenses________ 13
Commutation of rations:
Enlisted men_________________________________ 60
Hospital. ___________________________________ 39
Court reporter:
Civilian_____________________________________ 25
Enlisted men_________________________________ 24
Statement of personal services, civilians___ 26
Death gratuity payment____________________________ 56
Dependents:
Adopted child, increased allowance, officer_ 28
Initial family allowance, enlisted men______ 41
Mother, increased allowance, contract surgeon. 35
Travel, officer_______________________________ 1
Deposits:
Refund to contractor_________________________ 18
Soldiers: Collection_______________________________ 58
Payment prior to discharge_______________ 47
Donation, $10.00 payment, discharged military prisoner_________________________________________ 23
Donors, blood_____________________________________ 61
Electric current, payment for____________________ 14
Page
Enlisted men: Commutation of rations_______________________60
Final statement: Deceased (AUS)________________1_________ 52
Deceased (RA)__________________________ 53
Discharged for minority________________ 51
Discharged honorably___________________ 50
Partial payment____________________________ 60
Pay roll:
Final__________________________________ 49
Initial family allowance_______________ 41
Monthly pay: Regular____________________________ 40
Flying----------------------------- 44
Foreign service pay adjustment____ 43
Parachutist________________________ 46
Soldiers’ deposits: Collection______________________________ 58
Payment prior to discharge_____________ 47
Stenographic court reporter________________ 24
Travel: Government aircraft, per diem____________ 4
Prival ely-owned conveyance_____________ 7
Expenses, payment pn CPFF contract_______________ 13
Family allowance, initial payment________________ 41
Field rations collected from officer_____________ 33
Final statement, enlisted man: Deceased (AUS)______________________________ 52
Deceased (RA)______________________________ 53
Discharged for minority_____________________ 51
Discharged honorably _______________________ 50
Flight certificate and schedule__________________ 32
Flight Officer, newly appointed, with flying pay__ 37
Flying pay:
Enlisted man, monthly payroll_______________ 44
Officer married since date last paid________ 31
Foreign service pay adjustment:
Enlisted man, on monthly pay roll._________ 43
Officer with parachutist pay_______________ 27
Furlough and commutation of rations and quarters-------------------------------------------- 59
Gratuity, 6 months’ death, payment______________ 56
Invoice________________________________________ 9,12
Money order, post office________________________ 16
Nurse, promoted_________________________________ 36
65
TM 14-507
1 Dec 43
Officer: Pa«e
Aide-de-camp with increase for longevity----- 30
Allowance increase for adopted dependent child______________________________________ 28
Dependents’ travel---------------------------- 1
Foreign service pay adjustment with parachutist pay------------------------------------ 27
Married since last date paid with flying pay.. 31
Promoted, assigned adequate quarters--------- 32
Transferred, assigned inadequate quarters---- 29
Transportation request furnished, per diem.. 2
Travel by Government aircraft, per diem------ 3
Travel by privately owned conveyance--------- 19
Travel by rail:
Transportation furnished via other than official at greater cost------------- 21
Transportation not furnished------------ 21
Travel when' station changed while on leave._ 20
Uniform allowance, Warrant Officer----------- 38
Women’s Army Corps returning from foreign service------------------------------------ 35
Order:
Government’s and Contractor’s acceptance... 12
Purchase_____________________________________ 9
Parachutist pay:
Enlisted mon,-------------------------------- 46
Officer______________________________________ 27
Pay roll, enlisted men:
Final________________________________________ 49
Initial family allowance--------------------- 41
Regular monthly------------------------------ 40
Payments:
Aide-de-camp, with increase for longevity-- 30
Allowance increase:
Adopted dependent child, officer------- 28
Dependent mother, contract surgeon----- 35
Blood donors_______________________________
Chief warrant officer newly appointed, entitled to longevity---------------------------- 34
Civilian hospitals for care and treatment-- 61
Civilian nursing attendance---------------- 62
Collector of internal revenue, tax on unofficial telephone calls---------------------------- 15
Donation of $10.00, discharged military
prisoner_________________________________ 23
Electric current___________________________ 14
Expense on C PFF contract------------------ 13
Federal tax to contractor------------------ 15
Flight Officer, newly appointed, with flying pay---------------------------------------- 37
Flying pay:
Enlisted men on monthly pay roll------- 44
Officer, married since date last paid-- 31
Foreign service pay adjustment: Enlisted men on monthly pay roll-------- 43
Furlough, commutation of rations and quarters_______________________________________ 59
Officers transferred, assigned inadequate quarters_______________________________________ 29
Officer with collection for field rations furnished_____________________________________ 33
Officer with parachutist pay--------------- 27
Payments—Continued. page
Parachutist, enlisted man’s monthly pay roll. 46
Partial, enlisted men_______________________ 60
Post office money orders____________________ 16
Promotions: Nurse____________________________________ 36
Officer, assigned adequate quarters_____ 32
Rations and savings account, troop train commander______________________________________ 54
Reward for apprehension and delivery of
escaped military prisoner_________________ 23
Six months’ death gratuity pay______________ 56
Soldiers’ deposits prior to discharge_______ 47
Stenographic court reporter: Civilian_________________________________ 25
Enlisted man---------------------------- 24
Supplies: Assignment of claims_____________________ 11
With supporting papers shown------------- 8
Without invoice_________________________ 11
Telegrams----------------------------------- 14
Telephone services-------------------------- 13
Uniform allowance, warrant officer__________ 38
War bond issued_____________________________ 36
Witness for court martial, fee, mileage, per diem, civilian______________________________ 39
Women’s Army Corps returning from foreign service_____________________________________ 35
Per diem:
Transportation request furnished: Civilian__________________________________ 5
Officer_________________________________ 2
Travel:
Government aircraft: Enlisted man__________________________ 4
Officer_____________________________ 3
Privately-owned conveyance, civilian. 6
Post office money orders_________________________ 16
Prisoner:
Discharged, military, $10.00 donation------ 23
Escaped military, reward for apprehension and delivery------------------------------- 23
Purchase orders---------------------------------- 9
Ration and savings account, troop train commander________________________________________ 54
Rations:
Commutation, hospital---------------------- 39
Field, collected from officer-------------- 33
Receiving report, subsistence-------------------- 10
Refund:
Class A pay reservation-------------------- 18
Deposits to contractor--------------------- 18
Report of sales made by Quartermaster sales officer------------------------------------------- 53
Reward for apprehension and delivery of escaped military prisoner--------------------------------- 23
Sales collections:
Quartermaster sales officer’s report------- 63
Salvage or unserviceable property---------- 22
Services-----------------------------------
Supplies, other than Quart ermaster-------- 22
Schedule, flight certificate--------------------- 32
66
1 Dec 43
TM 14-507
Telephone, payment____________________________ 13
Telephone collections, unofficial calls______ 17
Statements:
Personal services, civilian court reporters__ 25
Travel by motor vehicle_______________________ 7
Subsistence, receiving report_____________________ 10
Supplies:
Collections from other than Quartermaster sales_______________________________________ 22
Payment:
Assignment of claims____________________ 11
With supporting papers shown_____________ 8
Without invoice_________________________ 11
Tax, Federal, payment:
Collector of internal revenue________________ 15
Contractor___________________________________ 15
Telegrams, payment_______________________________ 14
Telephone, services:
Collection_________________________________ 17
Payment_____________________________________ 13
Transportation request furnished, per diem: Civilian_________________________________
Officer___________________________________
Transportation: page
Furnished officer by rail via other than official route at greater cost________________________ 21
Not furnished officer, travel by rail________ 21
Travel:
dependents of officer_________________________ 1
Government aircraft, per diem:
Enlisted man_____________________________ 4
Officer__________________________________ 3
Privately owned conveyance:
Civilian, per diem_______________________ g
Enlisted man_____________________________ 7
Officer_________________________________ ig
Rail:
Tiansportation furnished officer via other than official route at greater cost_____ 21
Transportation not furnished, officer___ 19
Station changed while on leave, officer______ 20
Uniform allowance, warrant officer_______________ 38
War bonds issued, payment________________________ ig
Warrant officer:
Newly appointed______________________________ 34
Uniform allowance____________________________ 33
Women’s Army Corps returning from foreign service__________________________________________ ok
67