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;.-...-.- ;~::. ~:~~:~~~"~y' Sl~l. .~:Q:d '~I ~~~O~':B~yJ::.J.':y~;..-M::..' ~~.. ~ ...~.-" -. ..- .,. ~." RECEIPT DEPARTMENT OF 'COMMUNITY SERVICES . ..;.- ...._ .a.,. ... ..__ ..... _ "':="..._~~_ ~._ _~.'~ GENERAL ..-ORM HO. "~2 (I"!I!:V. 19~7J ~ N~, 2067 FUND CARMEL IN.. '---J!ia.t--:1 ~ /20 OZ- , ~ ~ () ...........0./ / ~ j::"-;; r1:: RECEIVED FROM ./~rn,. r ~u..<.~~ ;:'~./L-' $ ~lIiV7litl 'A..-I..> \~j.A'" /. ../ -------'_ /~V..AC 1.~/t'4"VU~_..--..--- -DOt:t:A'RS ~ loa v- 8'9.. () 2- f 1/ - 90- (J 2_,.. '..;.-:;.) .~/J ::l~ A '7',--;'.' 11, .' ,'~ p .....c~-'......,... .c.(/o/y;(.4..- /7'. t.:'-t L,/.j'.'-::' PAYMENT TYPE a AMOUNT /' ...... -, "I:.. ./ /J #~7 " ~ ... . , , I / I /.... ..-, /' t, , ., > ';..7 CHECK I. .?,./ M.O C,.,o(:.f~~~\~,('","1.-1.-aG.~--<..-i ..... ~ I AUTHORIZED'fl'GNATUJ;l!;: E.F.T C.C. B.C, 'OTHE~ . .,:""'.,' ,..' THE SUM OF ON ACCOUNT OF CASH