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Home My WebLink AboutReceipt DEPARTMENT OF COMMUNITY SERVICES ~~ ~ N® 2645 ~i "~.~ ~t;...~E.~-~.~...~ -° FUND CARMEL IN., L. f ~ ~~ °~ 20. ,..r RECEIVED FROM .: .- .. a .: ~.~~~`~~~~~~-~•~~~ w :.~- °! ~" . ~. r _ THE SUM O ~' ~~ ~ y°; ,Y~.~ ~~~..F~~ ,. , . ,~ f , ~ ; ~-~-" ' .. ~ ~, _ .:>>;:,~..~ .~ DOLLARS ACCOUNT OF ~~,~ ~: _ ~~~' , _ PAYMENT TYPE B AMOUNT '' •' `` CASH CHECfC+ ~_ `,N1.0 _ .'' •. ~• 4 ~f~ E.F.T C.C.~H.C. OTHER `_.... ... p`~ ._,., ~ ~'~~:._a~. ~~ :.•~,.,.• _ _ AUTHOR17rED SICi ' ATURE .. << "'~ • Peeecribed by State Board of Accouate, Boyce Forme 3yateme, Muacie. Ia. ~J. ~, 6ENEr~AL FORM NO. 9a2 (REV. IB-71