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STATE OF OREGON REMITTANCE ADVICE <br /> TO SIGN UP FOR DIRECT DEPOSIT PAYMENT SERVICE AND RECEIVE CONVENIENT,ELECT- `s 'c' •' <br /> PAYMENTS, LOG IN TO HTTP:/NVWW.OREGON.GOV/DAS/EGS/FBS/SFMS/PAGES/ACH.ASPX ON j f <br /> INTERNET. CLICK ON FORMS AND BROCHURES. THEN SELECT DIRECT DEPOSIT(ACH) <br /> AUTHORIZATION FORM. 4%0 <br /> WARRANT NO. t . ,v.�+ij <br /> 125053539 ' �' ; 1 <br /> JUDICIAL DEPT (503) 986-5600 <br /> INVOICE NO. INVOICE DATE INVOICE DESCRIPTION AGY DOCUMENT AMOUNT <br /> LANE COUNTY JU 042618 JUROR ATTENDANCE EXPENSE 198 VI142367 SIO 00 <br /> e rot -runt <br /> I q 10 / vds / 3: y i 3 ( <br /> VENDOR NAME ISSUE DATE WARRANT AMOUNT <br /> HAMBY,DOUGLAS BRITTAIN 04/26/18 $10.00 <br /> FOLD ON PERFORATION LINE BELOW C BEFORE DETACHING. <br /> STATE OF OREGON TOME STATS TPBASURER SALEM.OREGON <br /> 50 986-5600 PAYABLE THROUGH US BANK 96=10 dei WARRANT NO. <br /> JUDICIAL DEPT 1232 S--'; # 125053539 <br /> ‘5"),- <br /> PAY <br /> � « <br /> BFSD CHECK DATE + ^ <br /> �163 STATE ST rs^• <br /> ALEM OR 97301 04/26/18 F; <br /> ®<i. � PAY THIS AMOUNT <br /> $10.00 <br /> TEN AND 00/100 DOLLARS <br /> PAY TO THE ORDER OF: <br /> VOID 2 YEARS A ER DATE ISSUED i <br /> HAMBY DOUGLAS BRITTAIN <br /> 86441 TERRITORIAL RD <br /> VENETA OR 97487-0000 ED SIGNATURE--- <br /> , _ .mo-.. ,- ...... _. .. _.-. .,. . 9.., ,. , , _,u.., U �.^•'..�: nom""'- L mo., <br />