Box 22, Folder 2, Document 32

Box 22, Folder 2, Document 32

DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Mera

REQUEST FOR COMPENSATION FOR PER DIEM PERSONNEL

(Submit original only at close of pay period)

11/7/66

TO: DIVISION OF FINANCE AND ACCOUNTS Date

FROM: Office of Secretary
(Office or Division) (i eeRI

EMPLOYEE: Ivan Allen TITLE: Consultant

EMPLOYED BY:
Appointment effective
or Mage pt DS aplet ape a
Contract effective





Per diem salary $ 190,00

er

Pay period: - from: =. 49/6/46... to 11/19/66 19 incl.



HOURS WORKED
DATE

DAY es | wep | THURS| FRI SAT ES | WED | THURS| FRI
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

(Title of Supervising Officer) (Signature)







FOR USE BY PAYROLL SECTION