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Home My WebLink AboutReceipt Form Prescribed by Btate Board of Aceount. Bo:{oa Form. Systems,'Muncle, In. (')RECEIPT ( ) 1:ffPARTMENT OF COMMUNITY SERVlttS GIiNIEFilA.1.. FORM NO. :3!!;;: (REV. HI!)7) ..........,.".."..... ( /,~;.~~ ~;>)(c::.::~;...- t!';.~ ,//" N~ 2454, FUND CARMEL,)N:-r'c';/,d'" ,'f' c;::.:) ,/ -~..- / (: RECE1VED FROM :-:,...:?\r:. /") r.:(' ,?t, , '.- ,:,. " I/<;',~~f/_., , "" 20 cS~ '\ (.e f"._ -'--"7';'''-- ,ft ~,'C-;P;j.{:._. 7,';;::';(-, ,'-,r . '~" "r-M,__.~~:._r'-:. .._l(:.~.'.~"~,.''!'., \ f7. ~..__) $ ,/;9t? () 0 ~':...- ON ACCQUNT OF. . '. - . l,/:')/~i,5~, ().:') ~ (' e, "!;/';'__;--'~--" c.''il-;-:')/./'::, ,:::~~~--:-:=-'_.~.~:::> '-,r' ' If %(/ /J {/ ,~.I__-.~-..-., /'. ' II ~I"'~ rfi;r__.";~_~",,,,, L';./_-=-""'-,~.-,,,._,., l:~.rl .. _ f.../" .. ~_,,,,j {"") ~'~::'_'.~_'"i;"~ . 1".,'....,:;, '.- . l ./ 100 DOLLARS THE SUM-OF C~~~~ '0: Jo,;;,,' ..:,} i." '....~,~ ,/ /,<" "- ~.~ c""- ..~~/~,::~ PAYMENT TY.PE !l: AMOUNT CHe:dK-:"" . ~, J" ,...".'. r,', . I -...-........-.. -- ~^.~-,<.... _I:;~~~.~-... ..;:";:'.-~:"A'Ui'~,,?R.(Z'EO =IC;"N.~TUR~ E.F,T. c.c.a.c". OTHER., . ' ,. " , , "..;..'~.;~::~' :..:~~_.....~ ,;,d'~ =J~~~"":~=~~J.~~~~;{.I ':-_~"...b_..~~.~~~.:.:.1-_:.;,~~~~~~_~'-~~-..:~l~~~~~~~~~~~.:.~L,:...L~~~!ll'~'~_ ~_! CASH Mco ..,....