Loading...
HomeMy WebLinkAboutReceipt Form Prescribed by Stelte BOClId of Accounts Boyce Forms Systeme. Muncie. In. \'>, RECEIPT .' ( J ,~PARTMENT OF COMMUNITY SERV~S GBNERAL FORM NO. ~!:I2 4REV. 19971 .xj{~U/~~( N! 2313 FUND THE SUM OF ON ACCOUNT OF ../'l)/<~'i .20 (i Z.....,..- , .' .r"}'~: RECEIVED FROM (~~t~~u4..A"'-'I'i::Ied...I.:.;;tf:.... ~I.:,:~:~?():?;:Z; 1-"';7;'" . / ..-1-. . ,.9' 'j~' -t ':~U.J-{J A::-Fl'!:l-t,vJ,t#..-?,,/-tJ/{j i':.-l-tr{) /i.-tI...?f.t:4..L-P,." D1~{/0jlt.tt:r-'----'~::um:tJ(R s i 'l 100 ILlt -02 Dip 1/1 DLS () ! d:;;,,.!;~- I~ ".~ -'" ..;.j L' I ~1: ~ . J ,- '- " ~,,-, ,. " ,', ~.;i / \ I ,.....- ./ "';'I~ l.... ..,.i ,d ~,., ;1'" c> Zi ,."! './ l"_..~ CARMEL IN.. PAYMENT TYPE a AMOUNt/ i .',,/ ~;; .37' CASH dFlECK'~ . E.F.T c.c.l~,c OTHER !...... .:.~-"'.,n./X'.-c".,~. i'::o...;.;:;';~r,,-..d:r:(~:.',::.;~ AUT:':'QRIZE(S'iGNATURE M,O , . ',".. " " ,'.", " ,c- ; . ;,. ':', ",.. .::':, ,'. ~~:L:...:..:.~'.' .:;' ":;::'i;'::':~:::L::.l-.-.::i,~:~."",.:'~:'~::,::,:,j; i6S;~...':i.:~:[:Si~.i:.:~ c;:':':'. ,: ':..,;;,J:...;,::"",",.:..;,:,;:'~~~~..:..:.." . .', . . 2:;:L:;~"::.,_:.:.,,;~::~~2:..;.j '~:~''''''':: 'j..., , _ :;;",.:.:J':'~i;.,_:~~.:,"'-:,"-;:;.. ~,.~":':"'.".....:...-, ',:': .:...'_:'_::.:.-'._....:.::_~:,,:-:.:..':.'i::.::.:i.,: ~'..'~'. ~.;.~.: "..."'~:'._.'-....:.::....-=.....:.:...:~_..:.:...;..~