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RECEIPT Cate 5 ' ! Z 19 `�y No. 0698 <br /> aReceived From <br /> A <br /> A dres <br /> u aIlars 5' <br /> For — VA- <br /> ACCOUNT HOW PAID <br /> AMT. OF CASH <br /> ACCOUNT I - <br /> AMT. PAID CHECK <br /> BAIANCE MONEY <br /> DUE ORDER Y <br />