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RECEIPT
DEPARTMENT OF COMMUNITY SERVICES
1I11BIIRAL FORII lt~. au IRIIY. UIf)
C1~ FUND
CARMEL IN.. ~BL- .::2~ 200\
RECEIVED FROM ~D~ ~s~o-.. ~ff\~ ~<- S?$"O.e,u
THE SUM OF ~\\I,h'" ~~ "F\~~r ~ ~ -90LLARS
ON ACCOUNT OF \Lo~-o, p,.,G-L~ ~~ 100
PAYMENT TYPE 80 AMOUNT (Y)~ID\.~~ ~ ~
CASI-l CHECK~ M.O ~1''''''::--? " _
E.F.T c.c./a.c. OTHE~ AUTH BIG URE
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1849