P. RECEIVED of THE CROWN AGENTS FOR
Payee
Note.
This form must
the Sum of
in
t
filly two pounds 19/4
THE COLONIES,
refund of bave salary £52.3.9
Rd.
allee 15/10 paid to mr. s. Kelly.
Date...
10.4.31
14
Full Sum
£
Language
Sanitary Insper for period 23rd Sept to 31 tht but 1900.
either be pre- Account.
sented in person
at this Office, in which case it must be signed
The official Seenetary Commonwealth of Australia. Australia House. Strand.
Khung trang
in the presence Authority voucher
of the Paying Cashier, or it can be passed through a Bank after being signed by the Payee.
If presented through a Bank, it must be left one day for examination or for one hour if presented in person.
official Lecretary
bet.
£
SUM PAYABLE £52 — 19—
WELL BANK OF AUSTRAL
THE COM!!
Exd.
COTIA
Wan
NATIONAL PROVINOVAĽ BANK LIMITED.
Signature attor
date facross Twopenny Stamp when payment
amounts to
£2 and upwards).]
ODMAN HEALTH MANY DE CONTRALL
For Crown Agents' use only.
Y..
OFFICE OF THE CROWN AGENTS FOR THE COLONIES, 4, MILLBANK, WESTMINSTER, LONDON, S.W. 1.
CROWN AGENTS
PAID
23 APR 1931
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