Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Receipt
'RESCR'8W BY STATE 90ARb 0, ACCOUNTS '0."" "n..s. "UNtIE. "" RECEIPT (~ DEPARTMENT OF CO'MMUNITY SERVICES GENERAL FORM NO. 351 HU:~v.' !:'9-n Q~ N2 1 0 60 FUND 10 ()~ ~,~ MONTH [:lAY Y~AR n RECEIVED FRO~ u....\tlL- ~ .~ \""20-,,,,,. ~ THE SUM OF \'-~ ~ ~D \~ ON ACCOUNT OF 115-oc:, ~ ~ r- \JtL~~=- ~. PAYMENT TYPE "MOUNT w"""- <-C'--=1 /p CASH CHEC<lil!Q~ MO. ~~~ E.F.T. c.c./S.C. OTHER ' JlUTHORIZE IGN"TURE CARMEL IN., $ sro~~_ [)()LLARS 100