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INSTRUCTIONS FOR COMPLETING PAYMENT RECORD You must complete a separate Payment History Attachment form for each type of support paid. Enter the year, list the amount ordered, and the amount paid
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2001 2003 California UNREIMBURSED MC-031 X-ray FL-421 LawGovernmentalUniform DECLARANT Itemize foregoing reimbursement Respondent Parentage chronological totals Petitioner Spousal incurred COMPLETING yearly Attachment AB

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