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~ it :zY l <br /> <br /> <br />SERA#E' FDR: <br />NAME: #TY DF EUGENE <br />J~3~ ADDRE~; ~qT DN C#TY U#E'I~f NORTH DF VV ~ST'~ <br />PHONE: <br />~AN#E: ANNE A A~ <br />~~#~~#NC ADDRESS: ~2~ RpDEV'ELT BLVD <br />CITY : EUGENE STATES ZIP: ~~0~ <br />e l~#~~T# <br />f P#~DNE #~ 4~-G82~48~~ <br />DATE <br />~IID9 <br />ER~~D DED~IP~#~N <br />~I11D ~~~9~~~ <br />~b~ <br />~~ fi ~ ~~ ~~ <br />,~ 9 <br />-.A <br />`~r <br />.~~ <br />,~~~ tr~ <br />~~~ ~ <br />~"~ l <br />~ 4 F,,_}, <br />~°lo ~,~te ~e~ wtl~ ~~ charged o~ ~ca~nt <br />after ~ ~~ Past ~~ <br />~°~l ~ <br />~ .q <br />~~s'~~~ <br />L_,~ <br />~ . ,,~ <br />~~ <br />TOTAL <br />~3~.~~ <br />sup T~T~~ <br />TOTAL, ALIT <br />~~o.~ <br />$330.86 <br />7/Z Z/~~ <br />~~~ <br />~lr, 1G~/-G173I <br />`~~-- <br /> <br />Thank You For Your Patronage <br />