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PLC:

a0049c

Agency:

love county district attorney

For:

restitution

Phone:

580-276-9441

Address:

405 west main, suite 301
marietta, oklahoma 73448

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Middle:

*Last:

*Date of Birth:

(Month / Day / Year)

Case #:

*Defendant Contact Phone #:

(### - ### - ####)

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$0.00

Total:

$0.00

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*Last Name:

*Billing Address:

*City:

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*Zip:

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*Credit/Debit Card:

(enter the full card number without any dashes or spaces)

*Expiration Date:

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