Te Vn Septembe ¥ritten claim with defendant, the A full, on true fom enc he plaintiff 6 of a8 such correct Vellector copy thereof the filed emount of Internal is as its so peid, “evenue. follows: “Form 643 Treasury Lepartmens Internal Hevenue Service Nevised dune, i930 CLAI trey Colleater Filed, and will f1712 in Refund if ie 3 HE The ’ Oldeae ji ‘GH inéieate in tne che |certificate of Tax Illegally Refund of smounmt Peic Unused, or Used in of Asses of Rak EGR wi PRE ar ONSae Fee ie aS EE Bit cae block below on the UR AT the Collector's regener to STATE OF CITY COUNTY ee OR TAR of side. ; * claim Stamp (lete reveived) or taxes.) Exeess. not soplicable : purcheser of Business Hesi stamp Browning eddress 1132 #rms Spruce Company Street, Missouri ot. Louis, genes deponent, being duly sworn according A petits in which Missouri, #¢ to to lew, deposes and says that this statement “ts mece on dDehalit of the taxpayer named, end that the Tects given below ere true and complete: Fs 4 rae es4 2 6 2 {} Pe ea fe ¥ ah *he ge i t ee my pry y " ed EY) eae S ake oe ai return pert, ‘ ae Ee & “UF At ee Mae At KE ? =ro ee otamps, Error income PPL pede bods BISSOURT Meme thts The Tax estate or RE kind reverse Collected. for Py a Wks. WP ‘ Watag Pa hak he hte, AMF kage, Pi Bia 8h sit =aie G0 oe he ha ; } ae TE ‘ es a Kals ae 2ate BE reson, IRS (if none Ker SS Ri i ‘ Pe A eny) Tilec is Pape hier ee Sate oo ie a ey " “e. $ ae i *.EV was as filed to a < om Be *) whe {> Hale wate ei Bis PE, ‘ ‘ : : geCr ah oe 2 oe 4 y tea ee Rena 0% ae. 4 > mae g , Sais % A apt aS ‘ st Sie wt aes, “> E ee A fs af Je Pe : feae Gag i a a it ‘wy = & } es: eg : Hie engs Y i 1h tee ut gt a a * £283 petty Amount of sessessment date of vaymenk 1936. Dette stsamos were pur ‘hese PT pom : Government. March 16,