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					RECEIPT


BE IT KNOWN, that the undersigned hereby acknowledges receipt of the sum of
$______________ paid by ____________________________________ which payment
constitutes______________________________________________ payment of the below
described obligation:




If this is in partial payment of said obligation the remaining unpaid balance on this date is
$_____________.


Signed this_____ day of __________________, 19____.


Witnessed:

_______________________________

				
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posted:1/5/2008
language:English
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