TREASURY DEPARTMENT,
U.S. COAST GUARD.
Form 2661.
Ed. 50,000-F.C., Aug. 30-18.
Approved by Comptroller of Treasury
Aug. 28, 1918.
VOUCHER NO.______
PAY VOUCHER
FOR PERSONAL SERVICES AND COMMUTATIONS.
U.S. COAST GUARD{ CUTTER__Tampa________________
STATIONED AT__________________
APPROPRIATION:__Coast Guard 1919.__________
THE UNITED STATES,
TO Water Tender A.K. Bevins, deceased.__
ADDRESS____________________________
____________________________________
U. S. C. G., Dr.
MONTHLY RATE OF PAY __$55.50______
PERIOD COVERED BY THIS VOUCHER
FROM Sept. 1, 1918, TO Sept. 26, 1918,
INCLUSIVE.
CREDITS:
Subsistence___________________________
Commutation for quarters1_______________
Commutation for light and heat1__________
Commutation for rations_________________
Pay__________________________________ 48 10
Balance for'd from2_____________________
_____________________________________
Credit Adj. No._________________________
TOTAL CREDITS______________________ 48 10
DEBITS:
War Risk allotment______________________ 15 00
Coast Guard allotment___________________ 6 50
Insurance premium_____________________
Forfeited______________________________
Clothing_______________________________
_____________________________________
Debit Adj. No.__________________________
TOTAL DEBITS________________________ 21 50
Total Credits____________________$ 48.10
Less--Total Debits__________$ 21.50
Amount retained_____$
Amount unpaid______$______
Total__________________$21.50_
Net amount to be paid on this
voucher _____$26.60_
REMARKS:
Pay due the estate of Water Tender
A.K. Bevins, deceased, lost with the
Tampa September 26, 1918.
1 If for dependents, submit required certificate
2 Name of unit, noting month of roll or voucher.
MEMORANDUM COPY-B
EXAMINED BY
Certified by _______________________; approved by _________________________
Paid by ___________________________, Check No. _________, dated ___________, 191
(Name and title of paying officer.)
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