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124-126 W. Sycamore St.
~ .,.,c. .' , .. J':"'" . .." '\. .X,.... .....:CI""'.OF.'A.'N...n."IM.. :. ,.-~,1~f{;:', ,;.~,_- ..... _ .1.;.1. _ ' ~ , ih ..':).FINANCEiD~ARTMENT CQLLF;(;;TiOii$:OFF,~e~i.!RECElPT/DEPOSIT :\ '< --,,' y""~"l:: \ _>1) ...~'1~"-/~_/(f.(,:./cio~r:"~1:""~ 1~ ~ ,. ."" . . DATE: .. b--;r......./.':...20 or :';:. ":.'/~~~;Br~!~t~!D N();.' . :.-,., , : .,:::;:!.j~?;f':~M~t& 166765,_.'V '" :-.i~f:;"~ ".~~~~?:: ~1~~(:.;~~:~:: ~ " . :':'~ :;;~: :.- h ';,:E ','" .,', . ~_:J~~~.:)':: ,;~",j. . ,':<:~~.: .," /t:I"t (STATE) ""'<'-' ,',,' '- ..;,~f~~';':: <~J( . DEPOSIT BREAKDOWN:i , _,c ':':~~' ,-;<!;t,_._~~ "'.>~" . .., .;;-;, "{~~h:: \~~>_-:';'i .'~_<< ;'sir',:.-. ,'" "~ ,'?C' ..;;;,;~ c,,-, ;.' .'?-'r- xVI...... o'~tJ 10v~ x 2 32005 BurtolNG D!VISiOrf . . . : It. :.-.......:;;.. COIN: ," ,.' .', :' CASHAMO~:' . , '-. ',"; -,',- .,.,-,".:~/ '-i ',~;'" . TOTAL DEPOSIT: $ . ",i "" '.a.;-,--- ~'7, ::':':-: .,;,;),?;thr:~{~9t-~t(j\:~1~~if~~?101t~&i~jltt~0'-Z ,cr Datel ~/WIlS. 5t.'. Receipt'IlO::~'3~31!l8 ;:;;;";:'.~" . ',. .' 1::s~;fs~J;~i HI HlSCfllAlllOllS . 1: $%8 00 - . . n' ,,,.,'. .' 279412F724 '3817 . . oon:,~:'::'-' ::X"1,e Total tend~r~d ....U3MS;12F;.:';,:c~.;~1 Total paYI~nt. . '. ':~ $13345;12 (':: _ " . ;i;fi;IlS';:,r.{~~.flr~~g:~Vf~r . ""~ ' '''-. ,~-;;.; : ,.: -"1~;3~;f~I~1:Ji~t: , ,," _.'U Trans datel l;~ol\~'J itl~it~jr'~J'il~' ,.. G;;::YELLOW.'::.CUSTO , .~K:'RECOll!C '.y:i~GOLDE~OD":ORIGINATINGDEYI'- .J\;~,;i~~::Y~?'f;::;;t~!!;'1~:~~;~:'~-'~ :'~fr'~i~i'(, ;;-:'5fY:~";';' ',' . .