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TO ALL ELECTION. OFFICERS <br />tlemen: <br />Your bill is to be made on the following form. <br />CLAIM FOR ELECTION FEES <br />I certify that/ the undersigned were officers of an election held in Precinct No. <br />at .8c? e_r C--i -I�7JD r l' t4m <br />Position Amt. Due <br />Judge $ 3d o O <br />Judge $ ,3d • D o <br />Clerk $ D • b a <br />Clerk $ 3 J • 3 a <br />Delivering Returns <br />TOTAL $ <br />Name of officer holding <br />Mailing address C f <br />Sworn to and subscribed before me this day of , l9� <br />Designated Official <br />•a <br />• <br />F-103 <br />