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VI:::NJ:) .1: U 1:)o 1. <br /> REMITTANCE ADVICE 000007.09 -oo STATE OF CALIFORNIA <br /> THE ENCLOSED WARRANT IS IN PAYMENT OF INVOICES AS SHOWN BELOW. <br /> STV.404C(REV 116% <br /> DEPARTMENT DEFT.NO. INVOICE DATE INVOICE NUMBER RP <br /> 4i E::IF'1.7 (T E' I :I:SFI ANI:) (:iAME: 3fa00 12! 9/9 7.99 1�7°I " JIT ND <br /> 7.70 . 00 <br /> DEPARTMENT ADDRESS CLAIM BONED.NO <br /> 1.416 9Tt1 STREET' 0021914 <br /> SAC,RAME:NTO CA 91,'501.4 <br /> r�T —A:RJRER , aAN ..10AQUIN C0UN41 <br /> VEN� I UE3LIC HEALTH E)ERV:ITA:.S <br /> R: P . O . BOX 2009 <br /> 5T(.)CK7'0N CA 95201-0000 <br /> 1 00 <br /> FEDERAL TAX ID NO,OR BRAN RP TYPE TOTAL REPORTED TO IRB(BEE RPI'SI <br /> :This amount will be reported in accordance with Section <br /> 6041 of the Internal Revenue Code. <br />