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MONTHLY DUES
Jeorge H.
GAME COUNTS
Jul/Aug/Sep/Oct
Games
Worked
- ⑱ -
Payable Forfeits
- ⓪ -
Amt Due To:
Assignor
$㊱⁰⁰
FORFEIT LOG
⇓⇓⇓
NO ● FORFEITS
PAYMENT OPTIONS
Zelle
Andre Thomas
714-588-8781
Venmo
Andre Thomas
@Ace-Thomas65
ASSIGNOR'S NOTES
⥣ᴾdated 11/12/25
━━━━━━━━━━━
TOTALS
▸ $36 Dues (+)
▸ $0Forfeit (-)
▸ AMT DUE: $㊱⁰⁰
━━━━━━━━━━━
LMK if your records show different.
Pls remit by Nov 16
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