59836***RECEIPT***
Date: 11 /18/13
Receipt: 59836
Quantity Transactions Reference Subtotal
1 Op And Assy (1203) 13-5659 $200.00
Total Paid: $200.00
Notes
Payment Type
CK #6428
Amount Paid By
$200.00 The 4065 Club, Inc.
Name: The 4065 Club, Inc.
339 Route 82
P. O. Box 514
Hopewell Junction, N Y 12533
Clerk ID: JF
Internal ID: 13-5659