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					                       Bill RECEIPT
DATE [---------------- 00, 0000]

Bill Details
                                   CUSTOMER:
_________________________
_________________________
_________________________          [Name: ------------------------------------]
_________________________
_________________________
_________________________          [Address: ----------------------------------]
_________________________
_________________________



COMPANY

[Name of company]
[Address of company]
[Contact of company]




      Signature                                    Signature
      _________                                    _________

				
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posted:9/17/2012
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