Accepted by: (my signature) then below that Date: 00/00/0000 below that Acct# (social security number) and finally below that the code on reverse of my SS card.
Printed copy · Anthology Volume 8, page 51Printed copy from The Tender For Law Anthology, Volume 8, page 51 (printed 13 June 2014). Added by this site; not part of the Facebook export.