HomeMy WebLinkAboutReceipt Form Ptescdbed by State Board of Accounts Boyce Forms°-gems.Munde.in • GENERAL FORM NO. 952 (REV. 1!991
RECEIPT
DEPARTMENT OF COMMUNITY SERVICES No 1389
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CARMEL EN., �('"- aL9 200)\
RECEIVED FROM 7 ra :Z, s- , 1� ------ $ 1-16D,8
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THE SUM OF U Pic �� ' DOLLARS
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ON ACCOUNT OF try�s�arZ �CAa -I `1
PAYMENT TYPE &AMOUNT l
CASH CHECK 1 I • 1 m.o. e: / \
C AUTHORIZED SIGNATURE
V.F.T. C.C./8.C. OTHER