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DOC 0000017427
Page 346
346 / 583
JLHE UNDERSIGNED owner, 'beIng Uronsed to use t
Mifies thot the Renter land Renter’ ee
Agreement Is catitted to fully partici
> privérs
LICENSE NO.
WILU_RETURN™
22 co THIS..1S- YOUR INVOICE eo 20525 | :
TO INSURE PROPER APPLICATION TO YOUR ACCOUNT, PLEASE = wours @%
TEAR OFF, PERFORATED UPPER PORTION AND. MAIL: WITH |) pay g7™
YOUR REMITTANCE 7 ; :
SYSTEM LICENSEE -
AND ADDRESS. AND wad
EXACTLY AS IT owNER'S NAME AND ADORESS (Uso Rubber Stamp Balow)
SHOULD APPEAR], path aaa! —.
on AccOUNT., | ownER
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