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WJ

^[[checkmark]]

Mr. J.W. Schiffer
55 East 58th street
New York

January 1st 1922

[[underlined]]STATEMENT[[/underlined]]

1921
Sept.21 To bill rendered  $4.75

"[[ditto for Sept.]] 21 " " "[[ditto for To bill rendered]]  Frs.200,70

^[[pd]]