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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 /> 124952039 <br /> JUDICIAL DEPT (503) 986-5600 <br /> INVOICE NO. INVOICE DATE INVOICE DESCRIPTION AGY DOCUMENT AMOUNT <br /> LANE COUNTY JU 011618 JUROR ATTENDANCE EXPENSE 198 VI115004 $10.00 <br /> X19/00 — qui CFO-- <br /> STATE OF OREGON TO THE STATE TREASURER SALEM.OREGON <br /> 503-986-5600 PAYABLE THROUGH US BANK 96_10 riot WARRANT NO. <br /> JUDICIAL DEPT 1232 • 124952039 <br /> BFSD CHECK DATE p " <br /> 1163 STATE ST r Y <br /> SALEM OR 97301 01/16/18 +` <br /> PAY THIS AMOUNT <br /> $10.00 <br /> TEN AND 00/100 DOLLARS <br /> PAY TO THE ORDER OF: <br /> VOID 2 YEARS AFTER DATE ISSUED <br /> CHAN <br /> POLE R,�JEFFREY ALLEN <br /> 791EUGENE OR 97402-4527 AU BRED SIGNATURE <br /> VENDOR NAME ISSUE DATE WARRANT AMOUNT <br /> CHANDLER.JEFFREY ALLEN 07/76/18 $10.00 <br /> PC LD ON PEBFOKAIION LINE BELU'v yy uEtOK>:Ot SAlnNla. <br />