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58227***RECEIPT*** Date: 07/26/13 Receipt: 58227 Quantity Transactions Reference Subtotal 1 Op And Assy (1203) 13-4929 $200.00 Total Paid: $200.00 Notes: Payment Type CK #2892 Amount Paid By $200.00 The Church Of Sacred Mirrors Cosm Name: The Church Of Sacred Mirrors Cosm P.o Box 353 Wappingers Falls, NY 12590 Clerk ID: JF Internal ID: 13-4929