HomeMy WebLinkAboutReceipt
~
u
:5
IIorm PrElOcribed by 3late Bo...d of Accounts Boyce Forme SystlllU. ll4unci& In
RECEIPT
DEPARTMENT OF COMMUNITY SERVICES
8EIIERAL FORM 110. UZ (REV. 11871
C9~'--- FUND
CARMEL IN.. ~l \ \... 2oCOl
RECEIVED FROM~~~~ ~t\'~.L-~
THE SUM OF --.~......- ~"'~ ~''h1 ~
ON ACCOUNT OF II ~ I ~OL.<> ~
N2 1699
$ 3~ ~~
E.F.T
~
1 <:1.0 - DOLLARS
100
PAYMENT TYPE 8: AMOUNT ~
JA"'iJl""""'"~~
CHECK~ M.O
c.c./a.c. OTHER
~~
CASH