DATE:



| |

|DATE: __________________________ |

| |

|ACKNOWLEDGMENT RECEIPT |

| |

|I _____________________________________, hereby acknowledge that I received the amount |

|_____________________________________________________________________________ |

|________________________________as payment for ________________________________ |

|____________________________________________________________________________ |

| |

| |

|_____________________________ ______________________________ |

|Signature over printed name CHRISTOPHER F. CASTILLO |

|OSA Director |

| |

|DATE: __________________________ |

| |

|ACKNOWLEDGMENT RECEIPT |

| |

|I _____________________________________, hereby acknowledge that I received the amount |

|____________________________________________________________________________ |

|________________________________as payment for ________________________________ |

|____________________________________________________________________________ |

| |

| |

|_____________________________ ______________________________ |

|Signature over printed name CHRISTOPHER F. CASTILLO |

|OSA Director |

| |

|DATE: __________________________ |

| |

|ACKNOWLEDGMENT RECEIPT |

| |

|I _____________________________________, hereby acknowledge that I received the amount |

|_____________________________________________________________________________ |

|________________________________as payment for ________________________________ |

|____________________________________________________________________________ |

| |

| |

|_____________________________ ______________________________ |

|Signature over printed name CHRISTOPHER F. CASTILLO |

|OSA Director |

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