HomeMy WebLinkAboutFord - Assessment Fee - 6-9-26Date prepared:
Deposit Date:
Prepared by:
City of Atlantic Beach
Offsite Payment Form
06/09/26
Donna Bartle
/ RECEIVED /
JUN U 9 2026 x�
Payment Cash
GL Account or
Type Receipt
Accounts Receivable
Deposit
Code Number Description
Number
Amount
UN Assessment fee for Candidate - Curtis Ford
001-0000-369.90-00
139.62
ATLANTIC BEACH CITY
800 SEMINOLE RD
ATLANTIC BEACH, FL 32233-5445
United States
Phone : (904) 247-5800
COAB.US
Received From:
Date: 06/09/2026 Time:
2:42:49 PM
Receipt: 0000034829
Total Deposit
139.62
ITEM REFERENCE
AMOUNT
UN NON-SPECIFIC
Cash
ASSESSMENT FEE
$139.62
ACH
TOTAL
$139.62
Checks
139.62
CHECK 1076
$139.62
Money Orders
Total Tendered:
$139.62
Total
139.62
Change:
$0.00
Revised: wvwui
O:\City Clerk\INTERNAL USE\ELECTION 2026\Qualifying\[Payment Form- Curtis Ford.xls]Form