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./" I~ ~\ ( \ "1R~.PEIPT.. , DEPARTMENT OF GOMMUNITy.stRVICES :~,,-,~;~.q6 . ;:.):~ ':;.:;;,;,' . '~~ .>;:~':l;:',~~.f~i~ 00.1!)' N~ .1921 ,:,~l ,~J , :~J j~ :,:~ ,.~;~ '~j ;,'.~ /;1 ,,',~ /f1 .3 : <j' ':..\ ':~ .:i~ FUND CARMEL IN... ' .p"C": ,,"'"><, t r'-.-- .-7 .2qO C- , , . ' . . 'REGE:lV ED, FRO M/'~:i...!..~v..'1~~~":"'<A..",f.,'j . ,...} / -c~~~~:~i.~-",,:/ . _,'" :,,1' SUM OF ,,:,'1.~.i' l /.,,' ~:i:",,"i"~~'~'$':<<:1!lI' ":''''''~;Q ~'~~",~\""":' ~6 ON ACCOUNTOF./O )),;(1:2 //,,:':;.2 2 THE ...... . .... ,Z' V'. ... ... /";<(!,. ': ~t~.,,; ,?;'~%; /~t'4'~'/ .A'~,4;..-:t'~l~", ,.P\':"t:....:<-.. ..;.!<:"~t"IDOLLARS :/ ~~ LqLY,:/ "0';;" >/ . 100'" . -.1" I .."7 ;,.' - ,..,7, .. "'~{~ V'. .,F''- :or- ,,";.';;:A ."t,;/",,~..:.~,... ,;.;:.~. / PAYMENT TYPE' & AMOUNT " j~"" ,-<...;-' C~E'CK ,/ "':'; CASH "'/'-"" '''1..,1' '''~. rM,O: I ..~. t ," ,I /j l (....~;L. ;k;'~,~;(..-i,~",,'';;,oI'. ~ /.'l ;,,,, t......,...~:...,.~. tl"T"J............. -..,-~' f~~JI"",.~...~, ._,'- _.' <... r... ~r I~ c.." '., ~)J AUTHORl~t..,.. SIGNA'(UR.E E.F.T c.c./s,c. ,OTHER