HomeMy WebLinkAboutReceipt
Form Prescnbed by State Boare! of Accounts Boyce Forms Systems, MunClB. In
U RECEIPT W
DEPARTMENT OF COMMUNITY SERVICES
IIIlHERA&. FORM NO. ~ez IR'!tV. 1111""
~
N2
2335
CARMEL IN.,
FUND
lOP I 20tl Z-
(lY~ ~ ~!C:-$ 350-
~ Lu--LkiI. ~ r ~~OLLARS
/5L) -0:6 ;fD{ 1U/l.LCtrJ~
RECEIVED FROM
THE SUM OF
ON ACCOUNT OF
PAYMENT TYPE St AMOUNT
CASH CHECK tL:Oqt)M.O.
E.F.T
c.c./a.c.
OTHER
~~
AUTHORIZED. SIGNAT'7