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GENERAL53696
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GENERAL53696
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Last modified
8/24/2016 8:39:09 PM
Creation date
11/23/2007 8:51:24 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1988112
IBM Index Class Name
General Documents
Doc Date
1/17/2007
Doc Name
CD/DVD request form
From
Law Office fo Edwin Lobato
To
DRMS
Permit Index Doc Type
General Correspondence
Media Type
D
Archive
No
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DIV RECLAM MINING SAFETY <br />1313 SHERMAN ST ROOM 215 <br />DENVER, CO 80203 <br />303-866-3567 <br />TERMINAL ZD: <br />MERCHANT #: <br />VISA <br /># +:+*++*+++++0706 <br />CLK: SYSADMIN <br />SALE <br />BATCH: 007 <br />DATE: 01/24/07 <br />0001 <br />342709457254 <br />EXP.: **/** <br />INVOICE: JWD <br />SQ: 000009 <br />TIME: 09:58:05 <br />APPROVED: 019295 <br />MANUAL <br />REFERENCE #: 702916515754 <br />TOTAL $ 60.00 <br />I AGREE TO PAY ABOVE <br />TOTAL AMOUNT ACCORDING <br />TO CARD ISSUER AGREEMENT <br />(MERCHANT AGREEMENT <br />IF CREDIT VOUCHER) <br />SIGN X <br />CANDACE ELLIS <br />CUSTOMER COPY <br />
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