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LEGAL NOTICE CHARGE AUTHORIZATION
DATE: _______________
TO: GateHouse Media New England/Community Newspaper Company
LEGAL NOTICE DEPARTMENT
I hereby authorize GateHouse Media New England/Community Newspaper
Company to bill me directly for the legal notice published in the Lexington
Minuteman on X for a public meeting with the Lexington
Conservation Commission on _ X _ for property at
______________________________.
SIGNATURE: ______________________________________
Please print where to send bill:
Name: ___________________________________________
Business or Organization, if any: _____________________________
Street Address: ______________________________________
City/Town: ________________________________________
State: _________________ Zip Code: ______________________
Day-time Telephone Number: ___________________________
Email Address: _______________________________