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For", P,e"cr1hed by SIal. BCOld- 01 Acoount. Boye.. >'0,= Syetem., MunolG. In'
lMEHERAl. fORM NO. 3!i'- (REV. t IU1l
RECEIPT
DEPARTMENT OF COMMUNITY SERVICES
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1922
FUND
C ::J - j 0 .--...
ARMEL IN.. c:..~ Lfl .20~
RECEIVED FROM i~~w ~Co:-~
THE SUM OF ~'O""'L~':::' ~0~~~P. ~-~
ON ACCOUNT OF \'iJ-~~? \.J i .....'-'-~,.;s-. ~.:;~
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PAYMENT TYPE 8: AMOUNT
CASH
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