Autograph By: _________________________________ STRAWMAN Authorized Representative Address Processor:IRS Technical Support Division C/O The Treasury UCC Contract Trust Department of the IRS Department of the Treasury COPY FOR 1500 Pennsylvania Avenue, NW Washington, D.C. 20220
RECORDS Memo:
Cut on line
MONEY ORDER Tracking No.: -00001-MO
31 December 2008: DATE
Pay to the Order of: for $ .00
Pay: and 00/100 DOLLARS
Account No. 123456789
Autograph By: _________________________________ STRAWMAN Authorized Representative Address Processor:IRS Technical Support Division C/O The Treasury UCC Contract Trust Department of the IRS Department of the Treasury