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TO BE VALID THIS RECEIPT MUST BE COUNTERSIGNED BY THE SOCIETY'S CASHIER IT IS EXPRESSLY STATED THAT THE DRAFT, MONEY ORDER, CHECK OR OTHER INSTRUMENT GIVEN IN PAYMENT OF THE PREMIUM, FOR WHICH THIS RECEIPT IS ISSUED, IS ACCEPTED FOR COLLECTION ONLY. IN EVENT SUCH INSTRUMENT IS NOT PAID ON PRESENTATION, THE RECEIPT BECOMES NULL AND VOID e CACS 3281, 259M Sets 4-43-Premium Receipt Series

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