d. 
NOTICE OF SETTLEMENT OF FISCAL OFFICER'S ACCOUNT. 
* iii b i to D non ot ii 
IN REPLYING QUOTE INITIALS 
WASHINGTON 
general accounting office 
State and Other Departments Division 
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Sir: 
You are informed that your account for disbursements and 
collections from > " to — , n has this 
day been settled per Miscellaneous Fiscal Officer’s Certificate 
No. /* W and an aggregate balance found due the United States 
in the sum of $ .. . . Where balances differ from those 
shown by your account, an explanatory ’’Statement of Differ- 
ences" will accompany this letter. 
Respectfully . 
i p rl 
• • ^ ' vv X -J. j 
■Jomrtrcl 1 nr 
/O x , T r ..„„ — 
£ / ' ! c. &. vy . x.''; A’iiiNT OF A • I- ■' IL f v-»-’ : 1 | 
’ oiVKMO* ~ F >.X«;\TS AMD D: r ^^fGrtTS, 
t vri/MirnrrcM. c. o() /U ~ , 
r f cteti arjo (QZf-v&rued. 
H > r 
Miscellaneous Division. 
Form 4064. — Ed. 1,000— F. C., Mar. 8-17. 
Form approved by the Comptroller of 
the Treasury December 20, 1913. 
