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<br />`~ }'iY~^' III <br />:~ it i <br />Yl <br />~~ <br />a SER1f~~E'S Foy: <br />NAI~IE; ITIf DF EERIE <br />,I~B ADDRESS: S1 D~RN~R ~F ~C3UIVTY FARII~ PARI~C VIEVI~ <br />~IwI~N~ <br />BALL T~: _~.M_,.-.--.--.----- ...... <br />NAI~IE: SAME AS AE~11E ~.. <br />~ILLI~I ADDRESS: ~ 8~0 R~~SEVELT ~~.11D <br />CITY ~ EUCEIE STATE: ~R ZIP 974~~ <br />~4T° ~ KRITI ~ <br />I~I~o~u~ ~ ~~~ -~~~-~s~~ <br />°l~ ~a~e ~~e ~~~ be charged ~n acc~~~n <br />~~ o d~y~ ~~5~ D~ <br />~1 ~ d <br />Thank You For Your Pa#ronage <br />SUS ~'~TAL <br />INVOICE #11~$ <br />START DATE <br />~G1~~1~9 <br />~I~P DATA <br />~Gf~3f~~ <br />~~. ~~ <br />$~44.?~ <br />TOTAL AMT $244.7 <br />~~ _. lc~ _- ~C~c~ <br />rill-~~~~~_ ~~ ~~~ ~t-~~c~c~-I <br />~~ <br />DATA _____ _ RVIE D~SD~N~TI~N TOTAL <br />