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HOUSING MANAGER SIGNATURE DAT <br />OF;7CE USE ONLY � <br />SOURCE OF <br />FUNDS <br />AMOUNT <br />FUND CONTROL <br />CONTROL NUMBER <br />HOME <br />$ <br />AMERICAN BANK <br />GDBG <br />$ <br />IN -HOUSE <br />OTHER <br />$ <br />_ <br />TOTAL <br />$ <br />❑ AMERICAN BANK - MAIL CHECK TO PAYEE, EMAIL COPY OF CHECK TO RCS <br />Revised 7 -31 -12 <br />14 <br />25H -16 <br />