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Form Pre..,rlhecI by Stale Board of Acco....1Il Boyce Forma.S"8tem8. Muncie. In
U RECEIPT U
DEPARTMENT OF COMMUNITY SERVICES
GENERAL F.oRM NO. 35% caKV.. 18...,)
N~ 1677
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FUND
CARMEL IN..
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RECEIVED FROM
THE SUM OF
ON ACCOUNT OF
PAYMENT TYPE a AMOUNT /f
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CASH CHEC :1$<1 M.O
'S.J;.T C.C.I.B.C. OTH"EP
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