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40 Boston Street Salem News Form -IT HESALEM --' EWS REQUEST FOR LEGAL NOTICE I understand that by signing this form, I am agreeing to the cost of the legal notice to be published in the newspaper. Payment is required at the time of the legal notice being received by the city and before it is published in the newspaper. Please make checks payable to THE SALEM NEWS and mail to: The Salem News Attn: Legal Notice 32 Dunham Road Beverly, MA 01915 Prepaid cost required to run: $270 per day ***Important:Average legal notice costs are estimated;customer will either be refunded or billed after the legal notice is published. ** PLEASE BILL CORRENTI KOLICK LLP'S ACCOUNT DIRECTLY.THANK YOU. Check# ** (attach check) Credit Card—please call our legal notice clerk at 978-338-2512. If payment is not received,the legal notice will be cancelled. Signed Applicant/Authorized Agent Kristin E. Kolick, Esquire Print Name:Correnti Kolick LLP 70 Washington Street, Address: S ,i P : 6 Salem, MA 01970 Phone: (978)744-0212 Date: I?/Z �—