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STATE OF OREGON REMITTANCE ADVICE <br /> TO SIGN UP FOR DIRECT DEPOSIT PAYMENT SERVICE AND RECEIVE CONVENIENT,ELECTRONIC <br /> PAYMENTS, LOG IN TO HTTP://WWW.OREGON.GOV/DAS/EGS/FBS/SFMS/PAGES/ACH.ASPX ON THE <br /> INTERNET. CLICK ON FORMS AND BROCHURES. THEN SELECT DIRECT DEPOSIT (ACH) <br /> AUTHORIZATION FORM. <br /> WARRANT NO. <br /> 124937934 <br /> OREGON DEPT OF FISH AND WILDLIFE (503) 947-6186 <br /> INVOICE NO. INVOICE DATE INVOICE DESCRIPTION AGY DOCUMENT AMOUNT <br /> 2018-8 122117 DUES JAN-DEC 18 RIVERS TO RIDGES SWWDO 635 VP105978 $400.00 <br /> • <br /> VENDOR NAME ISSUE DATE WARRANT AMOUNT <br /> 12/28/17 $400.00 <br /> CITY OF EUGENE <br /> FOLD ON PERFORATION LINE BELOW . BEFORE DETACHING. <br /> STATE OF OREGON TO THE STATE TREASURER SALEM.OREGON WARRANT NO. <br /> PAYABLE THROUGH US BANK 96 <br /> 503-947-6186 -10 <br /> � � <br /> OREGON DEPT OF FISH AND WILDLIFE 1232 '-� .,r,04, 124937934 <br /> 4034 FAIRVIEW INDUSTRIAL DRIVE SE CHECK DATE <br /> SALEM OR 97302 ! ,""'" ' <br /> 12/28/17 Vyr <br /> ts� PAY THIS AMOUNT <br /> $400.00 <br /> FOUR HUNDRED AND 00/100 DOLLARS <br /> PAY TO THE ORDER OF: <br /> • VOID 2 YEARS A TER DATE ISSUED <br /> 18201ROOSEVELT BLVD <br /> EUGENE OR 97402 <br /> AUTH FiIZED SIGNATURE <br />