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SAMPLE Check or Money Order Do NOT write on back of …

OPT Fee SAMPLE Check or Money Order Do NOT write on back of Check / Money Order .

SAMPLE this ONLY" USE*'" FOR ACTUAL X Money Order PAY TO THE ORDER OF: Dept. of Homeland Security PURCHASER SIGNATURE Date $410.00 Four Hundred Ten Dollars 00 Cents ADDRESS; SAMPLE - SAMPLE - SAMPLE MONEY ORDER T intended for us. NOT intended for actual use. 00-123456789 NOT Sample Money Order NOT intended use $410.00 …

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  Samples, Order, Write, Check, Money, Sample check or money order do not write

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Transcription of SAMPLE Check or Money Order Do NOT write on back of …

1 OPT Fee SAMPLE Check or Money Order Do NOT write on back of Check / Money Order .


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