57524* * * RECEIPT * * *
Date: 06/14/13 Receipt: 57524
Quantity Transactions Reference Subtotal
1 Cert. Copies -Death 57524 $10.00
Total Paid: $10.00
Notes:
Payment Type Amount Paid By
CK #11231506 $10.00 Frank E. Campbell-The
Funeral Chapel
Name: Frank E. Campbell-The Funeral Chapel
1076 Madison Ave
New York, NY 10028
Clerk ID: JF Internal ID: 57524