DATE/ / 07 a 64 PLACE / r W e 54-P a , P ke -tc.L. L SERVED DATE/ 7 , O f ig 06 PLACE / i L/L/e..2462lk- L i FL- U i A- -r-r—csia, . L M 3e. ca. /Ca e n GL_ SERVED ON (NAME I b3 b6 b7' ir TITLE cr c.Lai STATEMENT OF SERVICE FEES TRAVEL SERVICES TOTAL DECLARATION OF SERVICE