seca Vac 1 Sap RRO PRLS TS UTR ReE SE REPRE F ANE OY pelt AURA LUPO MENTS fe LOCO fA So MRED od nny game ghar OnE HE PCS cae ra ted ex thet Three act deen acer ch Ioce reich -- °° form ony cther s urcee i i Patiadt VailTY tht (icfieate by *" strtarents s7plice ble). Ly OST om sinele citheus dependents in orme oo “¢ YI om sineles 74th e-coneents in orcas veer mee me ° ¢ YE en merricd cith-at ccpcrdents in orca. 5 & 0. € JE se mwrricé vith demxfants ia orca q '( )1 sea in trevel strtus fron BS et tele | ® I heve terxen heurs -f leave fren ; to Suri tris wericds i * “urrtore iad/er- mer 1s cere furcisned nme ce Prllowse i fea tue ae selfenoplice Vee of Pryce _appeewsd for peyrert en | a . Shen ture Title eel UHGHPY th-t the cbcve wyent hes been unde to the indivi¢us]l “Acse numer @ ee see Hog Feruired. if wruchor is siencd by yee “ith full ney roll sorte seme be copters thew. Grea Sign: ture of 7eCe mokine “Fyornt ‘te ac lerve ons trken or Af currters radf-r merle cero net furnished | éurire peri-d, crite “Y-ne in bionks. N-t reeuircd if ryvmt is in ececricnes with “ashiaeton gutherizeticne Sahat qa eet etme sac ncasong: apne GRE AL NE a TT . See am VOUCTER FRI GP Pere set RUD 7 eli /@R RTE CD C187 UT LIVID nuns F . “Fertod of 4his Vouchers Frm 12 dan 4 7 8 Peb 47 | : 0 Ban GH Mika OP os, PAUL RB. BROWN raitien EDITCRIAL ANALYST ee a ae aan: MAGSI-REte “ants Peyeble” © a a ore a ‘ “RY eareweeeceoenenee eenacesence <_ 4149,60_ 319,20 — 7 i a To ; € in 312220 tee? “y i ~  _ Tye Gurreney Rete of “chonge (rat ; 5 j : 2 BS Cf encunt cf eclery is ether then es outh-rized b7 Fereirn Buty Gf : ‘ : “$arot cr ctacy wffieial a eursr ats axmpliin here)e _: : ‘s “mrters «Liew nee * > cet eemre : ; i. Soest of Living clivesce * « _ ; : 3 “peck: 1 Peesien Livinn tlleence- * 3992 « 122.46 . . i ! e ‘Bid in |. © 122,46 H -tyee Currency “ste ef “xchonpe mw b) E os TCML 441,66 66 : I CEMTLEY thet I neve receiv? the rh-we emunt: 7 th surpsse one erica | : \
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