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MONTHLY DUES

Julian P.

GAME COUNTS

Jul/Aug/Sep/Oct

Games

Worked

- ⑬ -

Payable Forfeits

- 0 -

Amt Due To:

Assignor

$10

FORFEIT LOG

⇓⇓⇓
No Forfeits Reported

PAYMENT OPTIONS

Zelle

Andre Thomas

714-588-8781

Venmo

Andre Thomas

@Ace-Thomas65

ASSIGNOR'S NOTES

⥣ᴾdated 11/12/25
━━━━━━━━━━━
Totals
▸ ﹩⑯ ᴵᴼᵁ (last cycle)
▸ ﹩㉖ Dues (current cycle)
▸ ﹩⓾ Due to Assignor

━━━━━━━━━━━
LMK if your records show different.
Pls remit by Nov 16

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