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F...... Pr8llCdbed by State Board of ACCOIID18 Boyce FonDlI S7818lDll, Muncie. ID. _.c. . . .~. . RECEIPT,nw I ~ DEPARTMENT OF COMMUNITY SERVICES .....BRAL PORM NO. 3152 (REV. 1887l A-;v......, .r N2 2339 FUND CARMEL IN.. ~~:~',. L/.~.;>...- / ,/ ... '-.::/_.., C.... j/ -. 20 .to? .~'~' $ 33-0. 07::-, =y:.c..,.~. ,.. ......... . ?'~,,";? '-'-,~ DOLLARS 100 RECEIVED FROM THE SUM OF ON ACCOUNT OF C"::'::::".~;;{#- .,". /.., ........-...,~.....~ "'.~ ,.'d~/_ ,~') /"r, (,/Ci . ' . ../ .-/ 1'.,. /" . ,. A_-b.".'C.~._.. ( ,.._.<,,//{'.::. . /i ..". ," ?/ ,,4...0 CS /1/?IP,,;~/ ~. I':~ -, ;:. C ..,..",~..r....".... --~.....:;:~,..-- .' PAYMSNT TYPE a AMOUNT . '\ /.? ()',:..";"-;l CASH CHECIll\J>. , M.O \ ~;:;~:~:.> j'..- E.F.T c.c.fs.c OTHEP ---S:~':'~S;~:~::....--~;:i>l~'''\ 0-' ~~THORIZ~D- SI~A~URE J