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<br />--- ---------- --- _.- - -.--- --,- - - ~- - - -- --..------- - ---I <br /> <br />L. E;: rJ i fZ A \,.__. F' E l:~ M I <br />F'f:~::.C:O CUUNTY. FLOH 1 Li{:'j <br /> <br />CON 1 FU41'::.TUF. #: <br />NAME: K~L EDMOND~ <br />ADDR: 38603 CAMDEN AV <br />. i':."'" Z /H I L.t>, <br /> <br />FC'P ~ l,;E.::.;UUF\CE FEE <br /> <br />i';I!":CNl <br />11 It <br /> <br />Ten tiL rH1CIi.!NT ~ <br />CCll'1PI\\Y ACC(lt!I'H CENTET <br /> <br />I~4~"5t) .0- :::,~~(~.::::(~f~~;i) ,- <br /> <br />l~n::C:EI'v'fCD F;'i p___p':'.":"_,___,L" <br /> <br /> <br />i <br />i <br /> <br />! tN., Df:'jTE: (l(/1(;./9::: <br />F {\ I:; C : 1 elF I <br />T :~:;::;;UE OFI T CL: D <br />RECEIPl NUMBR: 00142052 <br />C-FF ICE: [lADE: C I TV <br /> <br />(_:Hf:,C:~( *1 1~?7j::f'7 <br /> <br />.J,. (;/t <br />~il"\UUI\IT <br /> <br />2' .:~) .. (J<~l <br /> <br />I <br />__'M"'~_ ~.._ <br /> <br />!~~E:::.!~:r';,: j F"T I c1r\J.. F)L::.fii~1.1' LI{:;'T(::'~ [iF,: i C:f;~ <br /> <br />*~":"*'R:'. f.'.l) <br />