The URL can be used to link to this page

Home My WebLink AboutReceipt __ ....,,~... ....-: ,~.., ~.,o<<",~. "'. 0,,:. r...e;..,,-- "n -.1'-..'-;'---- por:ri1'PnJBcribed by State Board ~f, Accounts BOyc8.Forms Systems. :r.lunda., In. U RECEIPT U DEPARTMENT OF COMMUNITY SERVICES GBNE.FI,AL. FORM NO, 3:!:i~ IREV. 19!:J71 ,;t,/ I i:", ,1/ .....'1/ pi .)'/ ,..17 ~A "," ""~r"'-'-- 1'.' .--, - . " J' N! 2502 FUND , .r.... CARM~L IN., ~'-7- ,1~ _"_./ ~;"""., I ," .~. '"""7 20(./ ,:.:-;:; (_---'.\ --r'--_. 1..:-;:'f';f RECElVED FROM' '-){.iAJ-!.,(,zAj ....(/&-?x.~ /:<,. /f"y, ""',' J' J/;.- -' ,. I ...< --";'.I~- 'I....._~,:,..O:"""_"".' ,.~ ~---~. r; r:. ,f~:;:~~~ $ /l'c~.. ("'S ,"--'I~'\' ~' 'ON ACC;::OUNTOF .::~} (; .- () :~;I (-,,'f'..:;;) ~, .i:~/ Jf' .d A't/"J.. / '.. ;I (" -'--'-- '// .~}l,tr:l~ '-"00 L:: LA R 5 ..";;' 100 U ./" <,r "",f j, ,'" " ,"A'/4(/PC./Ul",cZ( THE SUM OF ..I.~".;,;1:~-, ,"l ~'1~A~f PAYMENT TYPE 61 AMOUNT ,I ....:.i~U:':.t,,;:J:.4z-::v">.'1-;'i',.;:~:. ,./ , , /' 'li"';/'''''' CASH eHES,1<:' ' f.,j_',,; f M.O, ~.; ~ / -~ -:l--~~ A ~.I/ .AI ~Jt~ .~.....;t (~;?..--;fj)\" ........1'_."., J " .;~~ :~::,:~-'.,.(,~~,-c1 ~,,:,..'" ...,";'1;' /;::':?...-;.-f. AUTHOR-IZED::S.GNA T"9RE