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DEPARTMENT OF COMMUNITY SERVICES
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FUND
CARMEL IN.. . If; -I ;(2ot?2
RECEIVED FROM . W~aA7/-(' LL(2 S//(//'Io-fJz;
THE SUM OF tkt ~~ ~~ DoLLARS
ON ACCOUNT OF . 15:J-();2. PP r2-n/J~ 75~ l> lOci
PAYMENTTYPUAMOUNT/, f3-fJ2..Sf .fc;60 td~~
CASK c</c..!/'1i M,O, ~~
E.F.T C.C./B.C. . OTHER AUTHORIZE2 IGNAT;;fE