Form 73-333 - Prosecutor Office Apportionment Reconciliation Form

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STATE OF TEXAS
73-333
(9-07)
COMPTROLLER JUDICIARY SECTION
PROSECUTOR OFFICE APPORTIONMENT RECONCILIATION FORM
Page 1 of 2
SUPPORTING DOCUMENTATION
FISCAL YEAR
DISTRICT
GRAND TOTAL OF AMOUNT REQUESTED
0.00
EMPLOYEE NAME
POSITION TITLE
AMOUNT FOR DATES COVERED
0.00
TOTAL
I, ___________________________________________ , hereby certify that I am the
(Complete appropriate blank.)
PRINT NAME
District Attorney of the ________________________ Judicial District or the
County Attorney of ________________________ County or the
Criminal District Attorney of ________________________ County
I further certify that the account is true and correct.
Date
Person to contact regarding information on this form
Contact phone number
Contact e-mail address
(seal)
Subscribed and sworn to before me on ______________________________
DATE
NOTARY SIGNATURE
You have certain rights under Chapters 552 and 559, Government Code, to review, request and correct information we have on file about you.
Contact us at (800) 531-5441, ext. 6-5985.

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