Bill Of Costs Page 2

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I declare under penalty of perjury that the foregoing costs are correct and were
necessarily incurred in this action and that the services for which fees have been charged
were actually and necessarily performed. A copy of this bill was mailed today with postage
prepaid to:
.
Date:
(Signature of attorney)
(Name), Attorney for (party)
Bar Registration Number
Address
Telephone
[Facsimile number]
[Email address]

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