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Home My WebLink AboutReceipt ...,Vq ..! - '. ........,..............-..........u. ...... .......... ..... Form Pr.-lbecl by State Board of ACCOUDIlI Bovee Podllll Sy,l8ID8. MUDd-. !II . RECEIPT DEPARTMENT OF COMMUNITY SERVICES UIIERAL FORM 110. UZ IRIV. unl ----) (__.::~') L.;;,''6'S~.' :'::.r.:' '1...-... N2 1547 CARMEL IN., FUND ~jd-' 20~)'-J ' . .,......,'\ . / ,10-...'..... ( ) r, F'" _\-'t"'''':>-;. (;. ,1,.;/ i r -:.." (;.t:"/'\<:.<,.:::-" ~l .' / ,I ...-"\. . -'. r- , I _:.;:.2.~ . ~ ___.-I-~).,; -"'1,'",<<:~,.A <'~._l\':~ '1= ,'-F.,. ~I /1..,\ S:> I c,:::;-....-....-.eOLLARS \ ('\ . '/0./ Lt\,j - <::":7~.- (:::,1 . V\ (.;\ ).~"';"--:-I ;'~.J (-,-'-OI2._r..':'''''''"~~ <.,~ RECEIVED FROM .,' _.. '-. -...,'_'.,~"........ S' C,..''Sc . c., ~..' THE SUM OF ON ACCOUNT OF. 100 . "\ \~-, "-f... ~;. 2-.f'.....~ PAYMENT TYPE 8l AMOUNT /' '7~) I CASJ-I CHECK! C1/;:..A' ": M.O . l_-c.:.)--' -\ C~: >i, e:;!'-' i c.:..... . L -...........--.t; ~__.._-::> c:.'::"_~.' I'!} -~..."'..,-.....:..:~'.... C.)....~,.. ~~. ..::;::.~. ___:::,.., ...I/\,}'.....______.._..._ "'~~ltED s.aNATURE . -.-_.. I" ' '- '\. E.F.T, c.c./a.c. G!HEP ,,'"'.,. . .... dr ~~= ~ ~'-S';;:;:.l ~G:::> I .1 j i '~ ....-.... I I :1 ] " .i ! J , I ;1 ! -~-- ~-' ~-- -~_.. ~ ~ \8Q l..--t c.cx.. -"'\ \ 0 \-'t cE::'.