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Home My WebLink AboutReceipt Form Prescribed by Slale Board of Accounts Boyce Forms Systems, Muncie. In. URECEIPT LJ DEPARTMENT OF COMMUNITY SERVT'CES GENERAL FORM NO. 352 (REV. 1997) .47U'/" .c-t2- N2 2157 FUND CARMEL IN9~";,:,, 10 . ..' 20 QC>\ ? ,.. J r. ../ /.i . RECEIVED FRO~'~McA,(^7..v(~"c6:... /t";!'..;j',.c", . P 7.t.,~'.,.,_.&,,_) <:::'0. I /s~'). (.,'") D $1 c; .../ ..;-;?-e -e;rr:&.~,.v""""C- 'P-,?(..<- ._jr;) , ./' / ,/.. c:/ ..:r y." ~ <~:..._ " 7i.-q......,...';!.ILA-L~_, ("'(:.,'/~'f to(. ,.,,"", ,., &J ~ tI t..... '00 ~- ~cke r fJ9_ 00<. /) ./)4~ DOLLARS PAYMENT TYPE a AMOUNT CASH. CHEC~( . M~O ~::~?r,:,,.~~#-1~;~:-'-~""", "" AUTHORIZED SIGNATURE