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~c~ c <br />=j, p _ `v <br />CUSTOMER RECEIPT <br />DATE: ~ ~ I ~ (o ~ AMOUNT PAID: <br />#~ DOCUMENTS: <br />CHECK: CASH: <br />TYPE DOCUMENTS: REFUND: <br />~~ ~ a <br />STEVE MORENO <br />WELD COUNTY CLERK & RECORDER <br />BY: <br />Deputy Co Clerk & Recorder <br /> <br /> <br />