Case Number: 93D 00026
File Date: 2/25/1993
MILLS, JAY H.
Address:
P.O. BOX 431
PERRY KS 66073
DOB:
Attorney:
MILLS, LORALEE
Address:
P.O. BOX 23
OSKALOOSA KS 66066
DOB:
Attorney:
| Receipt Number | Receipt Date | Payor Name | Total Amount |
|---|---|---|---|
| 5898 | 3/29/1993 | MILLS, JAY H. | 100.00 |
| 1848 | 3/29/1993 | MILLS, LORALEE | 100.00 |
| 6299 | 4/30/1993 | MILLS, JAY H. | 100.00 |
| 6787 | 6/8/1993 | MILLS, JAY H. | 100.00 |
| 14567 | 8/4/1994 | MILLS, JAY H. | 178.00 |
| 14640 | 8/8/1994 | ADJUSTMENT | -178.00 |
| Description | Transation Date | Amount Paid | Payor |
|---|---|---|---|
| C/S CASH | 3/29/1993 | 100.00 | MILLS, JAY H. |
| C/S #MO SRS | 4/30/1993 | 100.00 | MILLS, JAY H. |
| C/S #MO SRS | 6/8/1993 | 100.00 | MILLS, JAY H. |
| C/S 82317994462 SRS | 8/4/1994 | 178.00 | MILLS, JAY H. |
| WRONG CASE (94D84) | 8/8/1994 | -178.00 | MILLS, JAY H. |
| ADJUST SRS | 8/8/1994 | 0.00 | MILLS, JAY H. |