Loading...
HomeMy WebLinkAboutReceipt u u .. RECEIVED FROM THE SUM OF ON ACCOUNT OF DOLLARS 4 .1 .J ij '3 ~l ..~ I j .I J i ., ,I j 1 i J POnD PrellGribed. lor St_ Board of Acico....ta Boyce FOrmll S~. 11_ III RECEIPT c1 ". .0 DEPARTMENT OF COMMUNITY SERVICES -"--~~"'--~/~ ~--- eaBERAL FOaa NO. lSa IRIV. 11871 N2 1814 FUND I ;;l )f') .2QCL t-- ~ I ..-r <:', ( " -;~::)r:l~"- :':l \ --\ d,1 b ;,':1 .'t;) '/ c::r::..,..;c;;:;;' f ~";' p-- "- \ -", \ f.l .- - \ 1" - '--' '.:) '.:.:;" T" t>1 "'.),;; lr--=:-:U 1'\' ..lC- .~. \ ~ r, '"':f, '- c:.\".,'> C:;" - ,~'- l r~;: :.?;;: ~~-"', \ ~,'b:::'.~:::::, f:~~~\t{\t"" ',.1_, ' 100 - ,"" \_.>. ., \ (~~\ . '1 r-....,' I .L. .-" I I, " .~.." r"), ' PAYMENT TYPE a AMOUNT ~"..F~' {'y..... \ ~-..I.I.:::, t'''~ ---,-P" a~~, I ~(~. ~,~L.L'(t7 --'''",,::::'.:) _)1 (;; 1'\ f\,t:.., ,,- CASH CHEC~ (~t., ';~; (:-;;'0 (~::-,=~~^~-) ! \ . , ' -.::;;::;'> f.__...' :,",., 'f1A....__._ ------____ c.c./a.c. OTHEP ( AuTHQijlZED SICiNATURE .........., ':--.....," CARMEL IN.. ,"-', "";[:"'" <tiJ-"'. .....'- <-,. ('" $ . ....~, ~ f ....-.. III!:.~/ - ..... .... . ,'~ -. .'; :1 i ~-~ ~l ;j 1 \ 'j j E.F.T