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' 06NiN~L IONN NO. 111 INCV. Bill ~ ~ ~~
v¢rlbad bT 9tab Board d ACCOYOb.. SriliID0. Mveas Ia _ •.. ~..~
R RECEIPT
DEPARTMENT OF COMMUNITY SERVICES
N~ 2720
FUND
C.4RMEL IN., 20~
RECEIVED. FRO /~g2rt;~~~ ~~ cxx~ Q`~~ $~~ ~ °~
THE SUM OF ~/~p-~' ~-!ti-~~`~ ~~ ,~-~ -~ ---'--`~ DOLLARS
ON ACCOUNT OF
_ PAV MENT TYPE O AMOUNT
CASK- ON ECK_~_~M.O /
E.F.T - C.C.~B.C OTNEc •urNONluo nen~rune '