HomeMy WebLinkAboutReceipt Form Prescribed by State Board of Accounts Boyce: a Systems, Muncie. In.
RECEIPT G[NERA, FORM NO. 301 (REV 19971
DEPARTMENT OF COMMUNITY SERVICES
2da.-K,c,_4a N0 2177
FUND �j
CARMEL IN., 2O`�
RECEIVED FROM iM 4
THE SUM OF .)4.e.1/64/..-' DOCLA
ON ACCOUNT OF V G' 2 �;.,6- r....� k' r,.-,,x-e)
PAYMENT TYPE B AMOUNT V -1 r
M.O as
AUTHORIZED,I
RGNATU
E.F.T. C.C./B.C.. OTHER i t