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[[horiz line across page]] MESSRS.JACQUES SELIGMAN & CO., 5,EAST 57TH STREET, NEW YORK, U.S.A. AM 15 [[horiz line across page]] [[preprinted]] Received the sum of _____________________ being ___________________________________ _________________________________________ _________________________________________ CHRISTIE, MANSON & WOODS LTD. [[/preprinted]]