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liS:!iltHA'i..".P'QRM NIiO". 'i'..... ,..--- .p~~by.Stat1!lEoard:OtAcC<>UI>i.. . Boyce Fomm SYBlemn. MlII1c1(t. In. - .. ... U . ,RECEIPT' ,U " DEPARTMENT OF COMMUNITY SERVICES N~ 27'14 //iAfiALLI FUND , CARMEL IN.. ? -/:3 20(;L.2 RE,C,' EIVE D :FROM ~~~~'_~u'-/~~~~/ / ~ . . $237#1 . c1-~ _. -ErJ THE SUM OF. ;...~ '" 'h<,/(</Uo.r~::~ 00" AQS qNACC~UNTOF : r) ~;;j?jJ. ;;~~~_,/i._'/-:r://'~ ,--"( PAVME:NT TYPE 80 AMOUN% . CASH. ' ctlPKjtJ 0/2 , M.a. E.F.T, ' c.e.Je:c. OTHER {?~_1~.I~:t~~.~~ " . ' ..' AUTHORIZE~IGNATUr ' . ' . ' . - . . - .' . ,.. ..__ _ _ __ __~ _ _ _ _ _ __ _." _ ~. ~r _. _., _____ __ ~." .-..- _.u ... ---- ...-- ,~...._- .... .'.'.'