Fillable SAMPLE INFORMANT PAYEE RECEIPT For and in consideration (U.S. Department of Justice, Office of Justice Prograns)

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SAMPLE INFORMANT PAYEE RECEIPT For and in consideration (U.S. Department of Justice, Office of Justice Prograns)

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SAMPLE
INFORMANT PAYEE RECEIPT
For and in consideration of the sale and delivery to the State, county, or city of
information or evidence identified as follows:
________________
__________________________________________
_______________________________________________________________________________
I hereby acknowledge receipt of $ ______________________________________
(numerical and word amount entered by payee)
paid to me by the
State, county, or city of _________________________.
_______________________________________ ______________________________________
Date Signature (Witness)
_______________________________________ ______________________________________
Signature (Payee) Case or Reference No.
_______________________________________ ______________________________________
Signature (Case Agent/Officer) Signature (Authorizing Supervisor)
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SAMPLE INFORMANT PAYEE RECEIPT For and in consideration (U.S. Department of Justice, Office of Justice Prograns)

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Completed 7 August 2020

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