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FORM129.DOC
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1987-09-24
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658b
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30 lines
RECEIPT
(Specific)
The undersigned hereby acknowledges the receipt of
_____________($ ) Dollars from __________________
in full payment, satisfaction and discharge of the obligation
dated _____________,19__ which is more particularly described
as follows:
Signed and sealed this ______day of ______, 19__.
______________________________ _________________________
Witness
Form 129