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I Invoice Voucher
Care Authority —Viindor�Cim,fi,,It.
PO Box 42691
Olympia, WA 9856 2691
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Cindy Carter, ChairTAX
IDENTIFICATION NUMBER
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MONTHNEAR OF SERVICE
i RECEIVED BY _.ATE RECEIVED
Community Coaliton CoordinatorA19
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APPROVAL:ACCOUNTING
APPROVAL FOR PAYMENTf DATE
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