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DIVI~ OF MINERALS AND GEOLOGY <br />RECENED <br />S°_ 2382~j5 <br />DATE J ~ ~ ~ '19 / <br />$ 9d <br />^ CASH <br />B,DkiECK <br />^ M.D. <br />AMOUNT 07'ACCDUM........ ..$ <br />AMOUNT PAID ....... ...........$ <br />(2 ~UOU ~ <br />B4LANCE DUE ...... .......... .$ BY <br />