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PO Box 12345 MyTown, ST 123451234567890123 1234City of Harrisonburg PO BOX XXXX Harrisonburg, VA 22801SUMMONS# PIN: View your video and pay your Violation with your Debit or Credit card at www.onlinecitationpayment.comNOTICE OF VIOLATION/SUMMONSR WAAmount Due: Court Date:This SMITH Summons can be satisfied and no further action JOHN will be ST necessary if paid before the Due Date. 1234 MAIN Please read reverse side for complete instructions. MYCITY, ST the 12345STATE OF VIRGINIACOMMONWEALTH
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Mytown ST 12345 is a specific form or document used for reporting certain information, possibly related to taxes or regulatory compliance in Mytown.
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