HomeMy WebLinkAboutReceipt
Form Prescribed by State Board of Accounts Boy"" i'onns Systems. Muncle. In.
U RECEIPT C:J
DEPARTMENT OF COMMUNITY SER~ES
13aNERAL fORM "'0. 352 (nEV. 1997)
THE SUM OF
ON ACCOUNT OF
~<...R./{4'J FUND
.
CARMEL IN.. COc-f- 50 20 c:> Z--
RECEIVED FROM ~;(~ LP $II':?O-
/ tf _ /J /.1 I i- PJ-IJ
{01u~~ 07LR ~~z/~ ~[LARS
I 'I-~ - 6;0 4- DL 'S 4vn..utC{ 13 ~(J 10
V - l~g"-Ia()..o' '7'70 A I/? -
PAYMENT TYPE 110 AMOUNT -ll <.. '0 --rv~4hl<.--
:l- cl1 r 8(..
CHECI<. ""l' i t"l 7'1 M.O.
C.C.fB.C
N2
2333
E.F.T.
OTHER
o
CASH