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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 /> 125940930 <br /> JUDICIAL DEPT (503) 986-5600 <br /> INVOICE NO. INVOICE DATE INVOICE DESCRIPTION AGY DOCUMENT AMOUNT <br /> LANE COUNTY JU 122920 JUROR ATTENDANCE EXPENSE 198 VI326813 ( 10.00.) <br /> LANE COUNTY JU 122920 MILEAGE 198 VI326813 $4.00 <br /> vm ?I-ege a€ fk5 10 • °° 40 S(0-( 471 l oo/cmo o f 3D <br /> 4-1910079107p7v1 o <br /> `C. zriori oo/ lol o/539/3o7 <br /> 40*Tk_k <br /> VENDOR NAME ISSUE DATE WARRANT AMOUNT <br /> HARRISON,KELLIE LOUISE 12/29/20 $14.00 <br /> STATE OF OREGON TO THE STATE TREASURER SALEM,OR EGON ., <br /> 503-986-5600 PAYABLE THROUGH US BANK 96-10 t F - WARRANT NO. <br /> o a <br /> JUDICIAL DEPT 1232 125940930 <br /> 11163D STATE ST CHECK DATE m ! <br /> SALEM OR 97301 12/29/20 <br /> ";—. PAY THIS AMOUNT <br /> $14.00 <br /> FOURTEEN AND 00/100 DOLLARS <br /> PAY TO THE ORDER OF: <br /> VOID 2 YEARS A TER DATE ISSUED <br /> HARRIISON,TKELLIE LOUISE <br /> SPRINGFIELD OR 97478-7183 AUTH RIZED SIGNATURE <br /> 1I' L2 59409100 ': L2320010Li: LO50Lu' <br />