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HomeMy WebLinkAboutReceipt Form Prescribed by State Board of Accounts Boyce Forms Systems. Muncie. In. U RECEIPT CJ DEPARTMENT OF COMMUNITY SER1'rCES . ,/ ":" :,(].l/;(~..a-f/ ./ CARMEL IN.. RECEIVED FROM THE SUM OF ON ACCOUNT OF FUND ...........\ (.1 .2, ( ) 20 () Z-.? .~ ..... oJ' . ,/ .' f. /,,: /// ,,;;:-? , -.l' /./.'//2./' .,/ {/ (j ./ ../Z.(./::':.,~(/,'-./(c.''..c.j // '.I ;~e~...'J./J;!..-/:C{",""'~~~'~ ' ' GIlNERAL FORM NO. 3!l12 (REV. III''''' N! 2286 ..,~v $ ? (/1) ,.:;;;;; --"--- -.------..--.. -. ---'-'O'OLLARS / (1 s:.' /'...., . ) ",' j"" // /~ :::::{' /1/' ,-/- //~.~. ,./ //? ';;0<-.._ PAYMENT TYPE a AMOUNT ./....U' /.JL,(i,., ., "'/~ ,.? ,/;<;/;;(;1~' !~ ~~',c...A...I-" ' ./,~(.;::/,; r-.' ')' . CASH CH"'.P. It. /\ (c~.. 1 M.O .' " ) 'l: C """';:4.,.",,1 . ~ {... rL. ' E.F.T C~C./B.C ."'i-'."',.-' '~': ;~~:::;.;.:,~.: j:~i~~.':{:j;~i:~',:,':;,,_~':,~"': .-... ;,.i;':.,':;: 100 '~:~~;~:~-r_'~l~'('::'~4. AUTHORIZEO.SjGNATUR...-,P. c:';'/- '.;j/ OTHER . '.;;-~'i":' ~'::, :,-' :: ;, :c"r~L''''''',,~''''"'~'''', .':.;:.:~~o\'~.o:"....:'_:.. WEST 106TH PROPERTIES, LLC City of Carmel Date Type 09120/2002 Bill Reference Filing Fee . o 108 -02 Sp \fJ~ {A41z40U- (AtiAV ~ f.?~&~ g) ~ 1"''7 I t-.z.. Irwin Bank Checking Acct Filing Fee - ::seconoary J'lat - carmel centre West 8050 (-} 9/20/2002 ~ce Due Discount 700.00 Check Amount Payment 700.00 700.00 700.00