U.S. DEPARTMENT OF THE TREASURY F01

U.S. DEPARTMENT OF THE TREASURY F01 BUREAU OF THE FISCAL SERVICE li BOX 51320 ELPHIA, PENNSYLVANIA 19115-6320 OFFICIAL BUSINESS PENALTY FOR PRIVATE USE $300 Forgery of endorsements on Treasury checks is a Federal crime. Maximum penally is a $10.000 line and len years Imprisonment. IF RECIPIENT DECEASED Deck ben and drop In mailbox. Cr:L.\ >,/ -'9:11":".C\ .1171 CI#V. if' rr;CIPVit aC IO i l et -Ati. 1 4 : r a r*.*1/4 i e t"1/1* X' a 4 > N -275e 1.4.0CS.,AVV.er. k• /FiL •iir "111 r , • 1/2 A.. Ehm /1, 4 • Hie (1A'::- z--z• it"-F--n . frxtbz4 s • re-\ fr-L-cee+,1Av-4.- Aid tc:-.444-4\ *4s .. "4174-4;%%Aftewl -ICCosr-t.ntliV.---,siolz,"-. .- *eat-77P 0-* ecnakotv. tev7.,*-airS'a--.0)411C4 g&<r0, Pas, it, at ty., tn. - • • 'Or Vat ckit:::11 Let 'al otr"--..r.. • A-. 1007-1 S4 152 O291 040 WU' Pay to the order of is-51 K 917,385,812 000 06 02 14 19000001 KANSAS CITY, MO 000215808770 4030 33178829 M DE= A OVERSEAS ISSURANCE State FIRST n ASS PRESORT POSTAGE AND FEES PAID DEPARTMENTOF THE TREASURY PERMIT NO. G-4 Check No. 4030 33178829 00000AH1426398 $*****110*00 VOID AFTER ONE YEAR c000000 s Lan 331788 29 2us 0 LO61.4 PROT0