60022***RECEIPT***
Date: 12/03/13
Receipt: 60022
Quantity Transactions Reference Subtotal
2 Cert. Copies -Death 60022 $20,00
Total Paid: $20.00
Notes:
Payment Type Amount Paid By
CREDIT CARD $20.00 Hengst, Mary T.
Name: Hengst, Mary T.
7 Ardmore Drive
Wappingers Falls, New York 12590
Clerk ID: JF Internal ID: 60022