Receipt for Check Samples

Citation
342 FW 4
Exhibit
9
Date
FWM
224
Originating Office
Division of Realty

(1) WHEN FULL PAYMENT IS MADE.

LA - (State)
(Unit)
(Case name and number)

RECEIPT FOR CHECK
 

United States Treasury check in the amount of ________________ ($_________) was received on ______________19___, as payment by the United States of America for Tract No.(_______), ________________________National Wildlife Refuge, _____________County, , being _______________hectares (acres) of land described in warranty deed dated _______________
19___ , and recorded on ______________19__, in the records of ______________County in Book __________page _________. This payment is full compensation for the land.

Dated at ___________________this ______day of __________, 19__.

**********************************************************************

(2) WHEN PARTIAL PAYMENT IS MADE

LA - (State)
(Unit)
(Case name and number)

RECEIPT FOR CHECK

Receipt is hereby acknowledged of United States Treasury check in the amount of ______________________($______) as partial payment by the United States of America for Tract No. ______, _______________________________________National Wildlife Refuge, ________________ County, being ______hectares (acres) of land particularly described in a warranty deed dated _________ 19___ , and recorded in Book ______page __________of ________________County on ______________, 19__. The above amount represents the total
                                             consideration of ($____________) to be paid for this tract, less
($__________________) withheld to assure payment of taxes and assessments for the year ____. Dated at ______________, this ______day of _____________, 19___.

___________________________

 ___________________________
 
******************************************************************

(3) WHEN LAST PAYMENT IS MADE

LA - (State)
(Unit)
(Case Name and Number)

RECEIPT FOR CHECK

 
 United States Treasury check in the amount of ____________________________________
($____________) was received on _______________, 19___, as partial payment by the United States of America for Tract No._______, _____________________________National Wildlife Refuge. Receipt is hereby acknowledged of United States Treasury check in the amount of ($_________________) as final payment for the above-described case. Full compensation has been received for the land. Dated at _____________________, this ___________day of ________________, 19___.

_________________________________

_________________________________