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Text File  |  1993-02-22  |  677b  |  27 lines

  1.  
  2.  
  3.                                      RECEIPT
  4.                                     (Specific)
  5.  
  6.  
  7.  
  8.                 The undersigned hereby acknowledges the receipt of 
  9.         _____________($              ) Dollars from __________________
  10.         in full payment, satisfaction and discharge of the obligation 
  11.         dated _____________,19__ which is more particularly described 
  12.         as follows:
  13.  
  14.                        
  15.  
  16.                 Signed and sealed this ______day of ______, 19__.
  17.  
  18.  
  19.  
  20.         ______________________________         _________________________
  21.         Witness
  22.  
  23.  
  24.  
  25.                                                         Form 129
  26.  
  27.