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Form pr(]6.cdbCd b~- State Board of Accol,;;,nts Boyce Form~ Systems. MunGia. In. RECEIPT " ~. lr?EPARTMENT Of COMMUNlTY SER~ES Nr2 2535 .~uL) ... FUND CARMEL IN.. . j ~ (: 2012-3 RECEIVED FROM ~~ .,;:Jd~::;/~(.'1- TH E SUM 0 F ," v' -//l...(~il.t?il.' --- / ON ACCOUNT OF ~C;':-O..:sS {7 - ,>"M'", "eo" 'MOU", ~/i yL If (~1! > :z.. , C^'" cHlLvs.- '2 < ~o. y !' - .> , . ,;; , . -----'_ ,'( ~'-/ -'- .~ ~E,;.-~ ~ E:.F.T. c.c./s.c.. aTHER AU"HOR~'- SIGt UR<': ~~/ $7 ll;/h ---=8~- 100 u u Form Prescrthed by State Boord of Accounts Boyce Forme Systems, MUD'L.."l9, In ~."'U::AA:" Fonfool NO. .!IltlZ InEv_ H"n~ RECEIPT DEPARTMENT OF COMMUNITY SERVICES N'~ 2542 d~~ FUND RECElVED FROM THE SUM OF -; 20 () -~ 1:;~7 "~~~ ~::-::?t-1J-(:.~ &1 - .~ " -- . 0 ~;J ON ACCOUNT OF 39.03 _Sf/ PAVMENT TYPE a AMOUNT " i('U'~1A/ /' . / II /'''''')-71 o' . C~Cl<' '7"" --.,)(r~t, d M.O. '-- CARMEL IN.. r') .") ,,.:5-/ ~/ /J ~.~. $0.'. rf /erV DOLLAR::= lOa E.F.T. C.c./s.c. OTHe:~ ,r.....} 'i . ",.1 ?!A~ /' Jl ~." ..~1 ,/ ( A51-?f ./U'_./;/~ \~___~~~,~A/ AUTHOIHZ,ED 50\ '&'ltJ't~./ CASH