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.rorm t't88cn1)ea aT .,tOolS IJoQ.l'a 01 ACOOWUU ".u~~ J'UJiWI;jI ~rllllo""U.. p'&'"'t,,;lUo uao GBNERAL FORM NO. 30a (REY. 19Q7) - . RECEIPT ~EPARTMENT OF COMMUNITY SER~\:S N~ 2282 Ge~,.--.".../ FUND CARMEL IN.. ~~ ~ 2~ RECEIVED FRO~~ ~ .. _ $ 3~ t5V THE SUM OF ~~ #7 v-".{,...~ DOLLARS ON ACCOUNT OF ~I- 7+-'-"'7 _ /.;?~O"'" ~~A;'~ ~/ /'P_ .. (--;''''/ t2 PAYMENT TYPE a AMOUNT ~cJ / c.....P7'l--<..y ~~.--,,~ 4A---7- ^---- '\/J~ /' . ~. CHECrJ( - M.a. ~. C.C.fB.C OTHER U AUTHOR EO SIGNAT'uRE CASH E.F.T.