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GENiiRAL fOI..' NO. !SZ (REV. lUYI
hu" Pr...crll:>ed by Slat6 EoOId 01 Account. oloyee For",. System.. :Muncle. III
RECEIPT
DEPARTMENT OF COMMUNITY SERVICES
N2
1935
a~.
-tFUND
CARMEL IN.=--~ l~' 2~' .
. RECEIVED FROM ~~<--> ~"-0
OF a~ k~~.~ ~~
dl-O:~,"S p QLA.'1IZo-L~'
,.,MENny".AMOUNT r:::-,:>~'""',,,,,,,,, I ~~~
CAsH CHECK , ~ \ M.O _ ---==- _-_ -
S.f'.T. C.C./,B.C. OTH'ER AU RlZllO BICONATURE;
$D.obL~
_ Dot.LARS
100
THE SUM
ON ACCOUNT OF