Form 105 - S.d.o. Itemization
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1S.D.O. ITEMIZATION
State Form 105 (R/5-02)
Approved by State Board of Accounts, 2002
S.D.O Reimbursement Voucher No. L.P.A. No.
Agency
Date Prepared
EIN
DATE
VENDOR
DESCRIPTION OF ITEM PURCHASED
OBJECT
IF
TOTAL
REPORTABLE
Grand Total
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Parent category: Financial