Box 22, Folder 2, Document 27

Box 22, Folder 2, Document 27

DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Me eay

REQUEST FOR COMPENSATION FOR PER DIEM PERSONNEL

(Submit original only at close of pay period)

TO: DIVISION OF FINANCE AND ACCOUNTS Date 2/16/66









FROM: Office of the Secretary
(Office or Division) (Branch)
EMPLOYEE: ____ Ivan Allen Ji, TITLE: Consultant _
EMPLOYED BY: 2
Appointment effective 10/27/66
or

Contract effective



100.90
12/h to 12/17/66 _, 19 incl.

Per diem salary §$

Pay period: From:

HOURS WORKED
DATE

DAY TUES | WED | THURS| FRI | SAT | SUN on | TUES | WED | 1
HOURS



I certify that I have performed services under the above listed appointment or
contract for the hours indicated.



(Signature of Employee)

I certify that the employee named herein performed services for the hours in-
dicated and request that he be compensated therefor in accordance with the terms of

his appointment or contract.

Administrative Officer

(Tiele of Supervising Officer) (Signature)









FOR USE BY PAYROLL SECTION