Dutchess County SPCA
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TOWN O. waPIIING..., NY
P.O. Box 324, Mlddlebulh Road
Wap~lng.rs Fall., N.V. 12590
Purch...
Ordlt' No.
DO NOT WRITE IN THIS BOX
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0111 Vouchlt' Received
FUND. APPROPRIATION AMOUNT
TOTAL
ABSTRACT NO. I
PURCHASE ORDER & VOUCHER
CLAIMANT'S
NAME AND
ADDRESS
Dutchess County SPCA
636 Violet Avenue
Hyde Park. NY 12538
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TERMS
VENDOR'S
REF. NO.
DATES QUANTITY DESCRIPTION OF MATERIAlS OR SERVICES UNIT PRICE AMOUNT
intake 11152 not reclaimed 155 00
intake 11156 reclaimed 0 00
I
TOTAL 155.00
--.
Jerry Owen 155 00
I. CIIItfy thet the 8bove ac:c:ounl in the amount of S ·
I. true 8Ild -..cl; thIIt the iIImI. HMcn. .nd dilbulHlllellll chIrgId ~ rwndellld to 01' lor the rnu.nidplMty on the d.... .wlld: thlt no Plrt hi. been pekI 01' ..U.llId: thlt ...... from which the
rnunlcipl/lty i. eqmpted. ... not Included: .nd thIIt the .~nt clltirned I.lctuelly due \
7/24/06 )'lA.-otA..-<!1\),,--_ Dog Control Officer
DATE L SIGNATURE TITLE
(SPACE BELOW FOR MUNICIPAL USE)
DEPARTMENT APPROVAL
The above services or materials were rendered. or
furnished to the municipality on the dates stated and the
charges are correct
APPROVAL FOR PAYMENT
This claim is approved paid from tha appropriations Indicated abova
DATE
AUTHORIZED OFFICIAL
DATE
COMPTROLLER
Dutchess County SPCA
636 Violet Avenue
Hyde Park, NY 12538
Invoice
Date
Invoice #
7/1/2006 262
Bill To
Town ofWappingers - ACO
Attn: Jerry Owen
20 Middlebush Rd.
Wappingers Falls, NY 12590
Payment Due Within 30 Days of
Invoice Date
P.O. No. Terms Project
Quantity Description Rate Amount
'/
fitl. W intake 11152 not reclaimed / 155.00 155.00
it 1.+1- intake 11156 reclaimed 0.00 0.00
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Past Due Amount: $ \085Y1~\i -
Total Amount Due: $ { dL{()X~,
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Total $155.00
SHELTER
INTAKE TICKET
Dutchess County S.P.C.A., Inc.
636 Violet Avenue
Hyde Park, NY 12538
(845) 452-7722
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Date {; /; 2 / rf.' <
Name
Address
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G~::: ~..J /} ,..'''i,j /..-v /.- 0 '*.~~
Town
Telephone #
Dog _/ Cat
Color 74v/ Iv I. ,Y
Breed /5() ..r i'-A-
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Zip-., 1
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Name t/&'JY'>.J:f[ilery''='j
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Sex ;-:
Misc.
Markings
Age '-/ DOl
,
Stray Surrender ~ HLJ<:O Injured
Remarks yr?LZJQlfne'O loc'},yOl.{J
Veterinarian
Sick
Microchip #
License #
Rabies #
Law Enforcement Remarks
Ever Bitten? Yes No
UYes, under what circumstances?
Uncertain
Has this animal, to the best of your knowledge, bitten anyone in the
pa~t ten dayf Yes ," No
Officer il./t"tJ c'"", I ) ?J--
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I, being tJ4! owner or finder of the above mentioned animal,
hereby agree that the animal specified shall be disposed of at
the discretion of the Dutchess County S.P.C.A.
This animal shall not be surrendered for the purposes of
experimentation or vivisection.
Donation
Cash
CC
Check #
DL#
Signed
Witnessed
SHELTER
INTAKE TICKET
Dutchess County S.P.C.A., Inc.
636 Violet Avenue
Hyde Park, NY 12538
(845) 452-7722
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Name
Address
Town
Telephone #
Dog ("C Cat
CoIO;~L~\ ("<~'Jl_(___
Breed'- ')-., .'-, \) .~
Stray ~
Remarks
Zip
,
~.h) I [-,
c~..,
Sex'....
1
Sick
Veterinarian
Microchip #
License #
Rabies #
Law Enforcement Remarks
Ever Bitten? Yes No
If Yes, under what circum,stances?
Uncertain
Officer
I, being ti ~wner or finder of the above mentioned animal,
hereby agree that the animal specified shall be disposed of at
the discretion of the Dutchess County S.P.C.A.
This animal shall not be surrendered for the purposes of
experimentation or vivisection.
Donation
Cash
CC
DL#
Check #
Signed
Witnessed