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MONTHLY DUES
Jason S.
GAME COUNTS
Apr/May/Jun
Games
Worked
- ㊿ -
Payable Forfeits
- ⓷ -
Amt Due To:
Umpire
﹩⑳⁰⁰
FORFEIT LOG
⇓⇓⇓
4/11 ● ED4
6/19 ● ED3
6/19 ● ED3
PAYMENT OPTIONS
Zelle
Andre Thomas
714-588-8781
Venmo
Andre Thomas
@Ace-Thomas65
ASSIGNOR'S NOTES
⥣ᴾdated 7/10/25
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TOTALS
▸﹩100 Dues (+)
▸﹩120 Forfeits (-)
ᴵᴼᵁ﹩⑳⁰⁰
━━━━━━━━━━━
- LMK if your records show different.
- LMK how you want to be paid.
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