The URL can be used to link to this page

Home My WebLink AboutReceipt form Prescribed by Stote Bo<U"d of Aocounts Boyce Forms Systems_ Munde: In. U . . RECEIPT () .DEPARTMENT OF COMMUNITY SER?r'CES (C:::"'/::./) P r-I? / FUND CARMEL IN., ~~c../ ~~~~ ~?;r-P: r:.-' Ofy .s;.'<.. r(r1..,,~r ~ i:.~",. . .p.f;~~:;;' ~.__,__~ /--.. _ ~ _,~J-:-/'./-h.....,...J~.......L_ cA.v,.'!:;>.. . .' ~' ,.(3 &'?< 20_ RECElVED FROM THE SUM OF ON ACCOUNT OF ;::> r- ~ /'>, ,-'.. . .,..- ":L-> ,.-4"_f';5.-c "'7/1 J . '1 / _ /L-;- '-'f o' /"" ~'l f/ - l-........,l .::::.r lJ (.)( PAYMENT TYPE 8: AMOUNT. kr~-,l.,.';;:i1_...v ' CASH. CHECK.' GE:NERAL FOJ:t,"'l NO..;315Z IRE-V. 19~"1 N'e 2256 ,....... ; .......---7' 6 -=?""..., $ ~.-'. C::o C/'J' 7<.,_ A ,O"""-.DOLLARS tOO ') .c.:.'-:-:.-::>-~.;.:;;;;;":':;;"'<"f.:l"'. /.~" ..:.;"'~.... AUTHORIZEO 'SICiNATURE M.O \ \ \ ,,/\0,C;I'i> // \ '- - - ...j ,.'-. . /('::-> ,.. ' ;' ^ ,A/' A '..,.\ .1,'/ ~ ... -,\ /1 8EJtCf/VtD ~\ ~~::l 13 2002c_,'; ~-\. DOCS /. ~/ '1:"-;\ / -"-. / \/>.." //.)' I "'" / ....- ...,.-('\ f. " ',-<~v/