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A V E E DETACH THIS STATEMENT BEFORE( OSITING <br />BONINE CONSTRUCTION <br />GATE IAN VOICETNO DESCRIPTION N <br />T <br />AM <br />O <br />U DDEDOU CTIONR NET AMOUNT <br />~• ///~~~~M ~~ <br />yI /~ ~ 0 <br />A//i/I.L^-~l ~ ~ OV/~~R+~ <br />I _ ~ <br />1/IJ~. <br />I~~ <br />I (~ <br />( <br />UULS YG ~ V IY l1i' <br /> ~ ~_~S y <br />~_.eee JUN 51984 <br /> ~1')') ~l0/'YL C fGC,S~t r ~-.~~ INED LAND REC AMAiION OIVI ION <br />~ umo. uepr. or rvamrai ReSOUrces <br />EMPLOYEES BONINE CONSTRUCTION <br />NAME <br />PAY PERIOD R RAT GROSS <br /> <br />ENDING HOU <br />S E <br />EARNINGS <br /> <br />F ~ c ~ <br />reo wrtN <br />Tex <br />sine[ w <br />TAx EARNINGS <br /> <br />PAID <br /> REG. T <br />O T ~ ~ <br />~ ~ <br />~ ~ ~~~~ <br />%i <br />~ ~ <br />I ~~V <br />~~ <br />~ <br />~ A <br />~~ /~~ <br />l <br />1 <br /> . ~ <br />- ~ IJ \ LJ V ~V/ <br />EMPLOYEE: THIS IS A STATEMENT OF YOUR EARNINGS ANO DEDUCTIONS FOR PERIOD INDICATED KEEP THIS FOR YOUR PERMANENT RECORD. <br />fV11NED LAND RECLAMATION DIVE N NO 1763 <br />1313 Sherman Street Room 423 <br />Denver, CO 80203 <br />~((p3~(0_3)~~866-3567 DATE to- 15 ,g <br />RECEIVED FROfvt~l )YI' \_ Af~~ ~1~~ \ 1. ~ C ~ l~-I (\) <br />THE SUM OF ~ I C ~ DOLLARS ~O O v <br />'.CAS. <br />FOR ~ Y~ ~LSZ.A~ ~~ ~ ~ C/~~SD~FCK <br />^MO <br />AMOUNT OF ACCOYJNT...... $ <br />AMOUNT PAID ................ $ <br />~oul <br /> <br />• <br />BALANCE DUE ............... $ BY <br />