Form PH 4z Form and Proof of Publication For Noticing Purposes

Worrall Community Newspapers, Inc. 1291 Stuyvesant Avenue P.O. Box 3639 Union, NJ 07083 Phone: 908-686-7700 Addre~ Service R~quested ads@tl1elocaJsource.cont Coluna Coffee & Cookies Attn:Chris Taharally79 Lessing Road West Orange, NJ 07052 Invoice Number j 314243 1l 7/3/2025 Advertiser No. Amount Due Due Date 221960 11 $0.00 11 7/8/2025 A fee of 1.5% will be imposed on all balances past due. Amount Enclosed PAID IN FULL l ·························· ......................................................................................................................................... , ...................................................................................................... ··············· .............. , .. ~ ... . Please detach top portion and return with your payment. INVOICE Worrall Community Newspapers Inc. Coluna Coffee & Cookies Invoice No. 314243 Item Dates Order No. Description - SubTotal Safes Tax No. of Ad Size Runs 7/3/2025 - 7/3/2025 143588 Public Notice: WOC-Legals: E143588 NJ Dept Revenue Filing - Bakery/Cookies/Coffee 1 20 Lines SUMMARY West Orange Chronicle Affadavit - $40.00 $40.00 WEST ORANGE Sub Total: Total Transactions: 1 Total: Advertiser No. 221960 Invoice No. 314243 Invoice Amount $47.20 Amount Paid $47.20 A fee of 1.5% will be imposed on all balances_ past due. News-Record of Maplewood and South Orange• West Orange Chronicle• Record-Transcript • The Independent Press • The Glen Ridge Paper • Nutley Journal • Belleville Post • Irvington Herald • Vailsburg Leader Union County LocalSource Please make checks payable to: Worrall Community Newspapers, Inc. We appreciate your business! CREDIT CARD - PAY ONLINE: laup://\\'ol'l'all-,INlin.<·om/\\'C~ Pa,·.html 71312025 Amount$47.20 $47.20 $47.20 --------------------------------------------Name on card Card# Exp Date Security# ___ _ Billing Addre~ _______________ _Billnag Zi1• ------ Auat PAID$. _____ _ Fed ID # 22-1012381