HomeMy WebLinkAboutReceipt
....... m...._ -. ~- _~_M - ---- -....u ~......1IUDClIe. In RE CEIPT
DEPARTMENT OF COMMUNITY SERVICES
u
IEBERAL FORII BO. au IRIlV. 11171
!jt~ FUND
.0
N2 1670
.cARMEL IN.. rt;: .. I
RECEIVED FROM K E" I
~ j :..-4~V~
::E A~~:U~~ ~~ ~~~>~i~' '-q-
I .- q ~~L~ ~~~
PAYMENT TYPE a AMOUNT .,- - -' 'J --e I
CH ../ '/J Y-,'S I~'~'" :/
EbLA. M.O ( ~..-( ~ ..( .' . ...Gt!~
I AUTHORlm..SIQHA.E
c.C: .B.C. OTHEP
,2oaL
-. r;. ,.,.
$3 ~Wil
-DOLLARS
100
CAS'"
'E.F.T
,_ PrllllCdlled bY State Board of AccoIIDte Boyce Forru 1lv8tema. 101"""'... III
1