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_ �� . <br /> � <br /> REFUND AUTHORIZATION <br /> T0: City Treasurer Date //�/,�-'9G� <br /> You are hereby authorized to refund the following: <br /> PAYEE: '�//QAJX1'� � j''� 1/' / - <br /> ADDflESS: �O � � �✓J/JY�- � f—ln <br /> ��,� �/�'°no� ��CJ� 9�2.Sd� <br /> AMOUNT: S �� �� - • <br /> REASON: � G417 ' � <br /> � . � ' � <br /> CUSTOMER <br /> ACCOUNT # OD2'.�2Z -' /ZOl'�3� <br /> This amount was received by the City of Everett on %//,�-�lv and recorded on <br /> �ae�vi <br /> permit or receipt number � �.�J 2 La <br /> //%��1� ^ -- � <br /> (dete) (Authorized SipneNr <br /> G��' C/�G �i <br /> � F e) <br /> Refund by Check No. Date <br /> _ Uriginal Receipt Attached <br /> Accaunt Debited: <br /> Or refund noted on Treasurer's Office Copy , <br />