CASH VOUCHER CLAIM by steepslope9876


									                                                 CASH VOUCHER CLAIM
S.A.&I. 270 (2000)
                                                                                        COUNTY, OKLAHOMA

                                                                                              Oklahoma,                           20
    In Account With
NAME                                                                                          ADDRESS

  DATE                                                                                                    AMOUNT          DISALLOWED
  20                                                                                   DETAIL             CLAIMED           BY CLERK


  The County Clerk Is hereby authorized to mail Voucher issued in payment of this Claim to Claimant at address hereinabove stated.

     I, the undersigned, upon oath, do depose and say that I have full knowledge of the above and foregoing account; that the said account
is just, correct, due and according to law; that the amount claimed, after allowing all just credits, is now due and wholly unpaid; and
that I am authorized to make this affidavit, so help me God.
      Subscribed and sworn to before me this                                                                                    Claimant.

day of                                    20
                                                                                  CLERK'S APPROVAL
                                                County Clerk              AUDITED AND APPROVED FOR - - $
     Claim No.                     Voucher No.
                           BY                           This form is to be used only in making claims for
                                                    money received through error by the County Treas-
                                                    urer, and for assessor's penalty, surveyor's fees,
                                                    side-walk tax, old law paving and other special im-
                         Against                    provement taxes required to be paid over to security
                                                    holder, and to such other Money as may come into
                 The Treasurer
                                                    the hands of the treasurer as is not required to be
                           OF                       paid out on bond, coupon or warrant.
                                                    19 Okl.St.Ann. § 691 reads as follows:
                     OKLAHOMA                           ''All money collected through error by the county
                                                    treasurer, and all other funds of whatsoever kind that
FOR                                                 shall come into his possession by virtue of office, ex-
                                                    cept such as is required to be disbursed on warrant,
                                                    bond, Interest coupon or depository voucher, shall be
                                                    refunded or paid out as the case may be, only on
                                                    voucher issued by the county clerk. No county treas-
                                                    urer shall, after having filed with the county clerk
FILED                                     20        any report of collections, make any refund of any part
                                                    thereof, except in the manner as herein provided. "

                                    County Clerk



            AUDITED AND ALLOWED                                       ASSIGNMENT

                                                    For value received, I hereby assign the within claim
                 For $
                                                    and, authorize the county clerk to issue voucher in
ACCOUNT:                                            payment of same to said assignee.

This        day of                      20          Dated this          day of                    20

                                    County Clerk.                                                 Claimant

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