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�- --- .. _ . ._.. _ .. ..., . . � �MTt�OARO OF ACCOUN73�o7et►eirt e�si[Yf.�u � �It. 3LNEML fORY NO. 1!2 It[Y• 11f71 � RECEIPT � DEPARTMENT OF COMMUNITY SERVICES _ - i; I�'� 692 . ;, - , /�'� ' '��/ FUND CARMEL IN.. Z � � �� ° MONTM DAY YfAN RECEIVED FROM L S`� �``-�=��w��� �6 � �`� ' � �,�, THE SUM OF � �`J��l� T�E'''u� Cv'i`%� i "-'��"DOLLARS ioo , ON ACCOUNT OF /�� ��-S � -ov ���-�", �— ✓ ,. , /� � � • ,�-k.�-,�- �,� ' � • PAYMENT TYPE a AMOUNT � P"' �2� .� /c�C °z � .� � �, p CASH CHECK � M•0• �'�.v��,��! ����-•j f�iQ,�aiT/1 AUTHORIZCD SIGNATUR6 �/ 0� EF.T. C.CIH.G OTHEr+ ��