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Text File  |  1991-01-10  |  502b  |  19 lines
  1.  
  2. Escrow No.________
  3. Date______________
  4.  
  5. Checks for Collection:
  6.  
  7.    On_________________________________________
  8.    Maker______________________________________
  9.    On_________________________________________
  10.    Maker__________________Endorser____________
  11.  
  12. Received above from:  _____________________ to be used_
  13. in accordance with written instructions in said escrow.
  14.  
  15.                                   _______________________
  16.                                   By_____________________
  17.  
  18.  
  19.