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l'i:~J:i{~IQte~Q~~:,oJ-"!"C<lUD!~"!IO~ FO~~~:~"f'!~c;>B'::"">':;::I.IEC'EIPT;'" .......... ... .' .. . .. D~~TMEN~6F COMMUNiTY SERVieEP . FUND s/.9":/ 20.tJ '5. .. p ~ C &,v- . G-y~ .$~~ ;16"'-;;:" . ~bv,,?WJ--Iw@Lf cR.;glk~..~. _.:..-/ . ~ I U. . DOLLARS . . 4g 43<< 2.-1.,-<.) (iS~) { ~_::l,M<- rl} ..VMENT TV'" AMOHNT Lf g - 0 3 b ?-- uJ (72-",:9-') /JtpJ,~~ O:..sNOHEOK "1171 ".0 ~. E.F.T. c.c./s.c OTHER ' ,ff' AUTH'ORIZE.P SfClNA-(y.ft".. .J~ CARMEL IN;, RECEIVED FROM THE SUM OF oN ACCOUNT OF 2656 . N~ ('.. .'_, RECEIPT . . D~~~ M"'e",} OF COMMUNITY SERVICU " "~"'- ,. . '->~1-'_, ' '.~:2 ,':.t. FUND CARMEL:IN., . 3/ / ey/o . 3 . i 20____ .,--''1[." "-'-I' . n I /_~,"" ' . "'.C, ~ ~ I V 1lLJ...,", .../1,1 II .. I,' I '- ~- ---:_~i A~j'1"~.' ;--.., /I'U, / 1 " +r "AA.I(:' ~ A. .A/J . t/-?1/0:3 ,r:> (1/ ItBt-_c) . t l,if, 3 dJlg {4 ' ,\7PJ.A.iJJ.:lAA /V ~'}/;{ ji.J.,A~(A\_2 ,/:' '1/?1t~tA~4-4JZ.~ ilUTHORlztlO SlctNATURI! " .......'" ..' '. ", ""'. .... ..' .' ...... ........ ...., .... .'. .1 ~'~~""""'-"--'-~~EGUfM';-FE.~UP.ES'~il'C'Ro :"~iNT ';:oP',''-BDTT(JMBis'i\~':"~s . CO~O~~D';~n=~N ~o;IF~i :, ~'E~;;;"""?-i.~'''''':'~~'.ll",,",~-~.';';~~~''''''''~--'_--'d,~",:_-j._-,",,~-'-'-' ,t=. .,. I.... A_ WA, Rf..1ARK ON REVE:RSE SIDE . ~..llS~,ING FEATU,~J;: IND1CA7E:=S A ::apy ~, ~ 2, 0: ...ItPJAJA;a j ,", ' ~; N, ~.. ~; OJ' ~--~: :::E: -RECEIVED FROM , ' THE SUM OF ON ACCOUNT OF ~: ~. ,,' -,' 0' i', ~: 2562 N~ " 'j :l , I.c:(l'-'~ $,:'/Ir/..., . , (.AS:..h::: .' ID0I10ARS----- '.:q;. ) .'~;;r. ,'-i . ~: :'RS . -'~ ';' .-'_: ~I ",j'" '.',j '"'::1 ::-;,': - ~ <'f L .PAYMe:NT TYF'E8I AMOUNT l' .' --, -T " . 1 ./ " CASH CHECf. . I~ I~ M.O. ,.,;= 'E.F.T. ,. C;C.(s:i:. :-i OTHEP O...L~. ~,,~.::.~!,-' ~~JjC~:!