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HomeMy WebLinkAboutReceipt w (j ./:~ , Form Preserlbod by.slc.lo B..",,, oU\ccounlS Boyce Form. Srst""'s, Muriel... In. RECEIPT DEPARTMENT OF COMMUNITY SERVICES C1.Ml!:RAl., FaRM NO, :!I" tREV. .&9') N2 1961 09 V""'-----..~~~_" FU~D CARMEL IN., J .Yl~-;-.;...,j, -S~o~ RECEIVED FROM ~t\I.p"';\ \ - I ---\'''-A. ff-.~~ 1\)"""'" (-'o..i"? r- --' -c-.. I ^ ~ THE SUM OF /; J'- <~y.. \-''<:::'I'~\ ~ n., r' t-\r-\U rC.c::: + .. ~--9QLLARS -:'") .,-~ ) f\ r~. -=:. ~, ) 100' ON ACCOUNT OF C7I -{L_~ ("'\ 't;}L ~, r \yY\~~ r.:::c \..-&'r-\ L.- 1:;~.P'>'~'l..~..-.:r\- . ~_:.'~-..J, ~r'E-=:" PAVMENT TYPE So AMOUNT' - ~ )f CASH CHECK- & :23 l} ~~..--. (,; i. 'I Jl. -, M.O. -- .~ -", :;c~~::l._ VV~~v"li--~ ( AUTt'{ORI1:ED 51CiNATURE: . , ,.....~ .~" ..--.., .....:::::.c::~, ~ir "j $ <::::>'- ... ""-.. >""--' \ 'I .! ,"-l=.T c.c..(a.c OTHER