CVU Sy FORMI FA.4.P
STATS OSTARNWT OF EDUCATION
AMC COMMITTEE oN INTmEmu REPORT OF
 ACCOUNTING
 1047 MONIES COLLECTED


NO.

+ulr


DAI 19 -


 (SOURCe OF COULCTION)

TIANSMITS HEREWITH MONIES. OBTAINED FROM SOURCES INDICATED SLOW FOR DEPOSIT

 SOURCE
 (IF FROM STUDENTS. LIST NAIMER IPARATELY)


IHF


 TOTAL FOR DEPOSIT

 I HEREBY CERTIFY THAT THE ABOVE FUNDS ARE LL RECEIVED BY MI FOR .
 DEPOSIT DURING THE PERIOD FROM,

 Is- TO 1 T-


 SIGNED IaSPONsO OR UnACTR)

 RECEIVED
 SIGNED (CMOOL TKASURKR OR PRINCIPAL)

PREPARE THIS FORM IN DUPLICATI-OTH COPIES TO TREASURER WHO WILL RETURN DUP.