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\: ; . ,0 " 'Form~.:...u...s!IF Stale Soard of~r. SO;"" ~S~l~' MUD~~ ~' RECEIPT DEPARTMENT OF COMMUi\lITYSERVICES C" 6EJ1l!RAL 'FOU' reo. n! lREV. I'.,., CARME:LIN~. , (; .~ :; 200/ RECEIVEO FROM ',A::t;,.(?;X~.A_..e.,? /;.).~__ ' ,', ," '\"flel#" , '''' '\..u~ THE SUM' OF "y~~tJLt~~~/~~:~7~ ON ACCOUNT OF 71-o//lDLS ',:< ,,', ,'Q"Y~ $/,5 ();;() <& ',',' / .> ..~\ N~ 1626 FuND 100, DOLlARS ' PAYMEN:rTYPEIIo AMOONT / " , //,. ,',', '.. '.....-"1' "" ,',' IL:i~;i~;~tt;ji~UO~=~';;;EJ;f'"i;'~':ii~~0~1:~14~"~;~i"ii~, "i