Laserfiche WebLink
67/26/2067 12:38 9524916665 MCE PAGE 07/67 <br /> , ' DIRECT PAY FORM 7 7 0 9 4 9 <br /> � � ����� ���lya� <br /> DATE: °?� O!I /YI�4l�g�,�/y1!� <br /> i <br /> . ��o �K e� � <br /> Please pay to. � �' 6� <br /> Address: '� ' � � <br /> , <br /> . . � � • � ' <br /> � ����►fr� � - I oU-�d-e T4x � � 3�� <br /> � <br /> ���w � <br /> � <br /> � <br /> . � <br /> c� � <br /> �- � <br /> ` � . <br /> � � . � <br /> V� �. , <br /> e� ' <br /> � � <br /> � <br /> � <br /> � <br /> . , <br /> � <br /> - - - �� - - - -- - - - -� - - � - - � - - � - - - -- - - -- - - - - - - - � - - -�$�� — <br /> Total amouM to be paid � � <br /> � _ <br /> ' I I M1��-�J ' <br /> INSTRUCTIONS: S� '� <br /> -� <br /> 1. Please give full des ption. 3. Remove: White Copy - O�ginal <br /> Goldenrod , Purchasing <br /> 2. Principal must s' n all direct pays. Blue - School <br /> . Ple se�qnd white and goldenrod copies to <br /> •-^� � ac,o �(payable and keep blue oopy for your <br /> • ��� � <br /> BUSINESS`O�FICE USE , i <br /> �. o a a I I I J <br /> �__..__._� �.. Annmv�cl hv .. <br />