Henry Atkinson v. George R.H. Clark, Executor of the Estate of William Preston Clark
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Office & In Co
St LouisSt LouisOct

Recd of G.R.H.ClarkG R H Clark Esq Executor of Geo WmWilliam Clark ClarkWilliam Clark sixty
five dollars it being one years premium on $ 5000. insured
on his Block of buildings at the corner of & Vine
Streets in St LouisSt Louis on Block No. 12 at this Office

J. Davis

Secretary