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0 01 <br />Kittitas County -l&J Grant <br />Law & Justice Grant Reimbursement <br />When submitting for reimburs~ment , please complete the follow ing information to accompany your <br />invoices. <br />;of\. <br />Please send requests to : W ,fK <br />" . \1-·,\1 <br />Date <br />Grant Number <br />Kittitas County Aud itor <br />Attn: Accounting Department <br />205 West 5th -Suite 105 <br />Ellensburg WA 98926 <br />1-30-17 <br />d:i-(7-(7 <br />Name & Address of Organization ,vE /L. .. MVlS)~R. <br />Requesting Reimbursement EI... LE AlS Ic,vl~b HI&11 Sc. fk:; 0 L- <br />/20 g e .. C/lPI17J L. AI/C . <br />Name of Person submitting Request Me-II" MI..tS}€i?. <br />Contact number S"tJ '? rc,9. t:t~'/ <br />Amount of Reimbursement ~ S'OO. 0'1 <br />If you have questions, please contact Auditors office 509-962-7502 <br />Auditor's Office use only <br />Total Authorized $ <br />Amount of this request $ <br />Previous amount requested this year S <br />Balance Left S <br />Entered into Spreadsheet .. initials <br />Auditing Officer initials