Harding, Mitchell- Assessment Fee ReceiptDate prepared:
Deposit Date:
Prepared by:
Payment Cash
Type Receipt
Code Number
City of Atlantic Beach
Offsite Payment Form
06/14/13
06/17/13
Donna Bartle
Description
Received
JUN 17 2013
Office of City Clerk
GL Account or
Accounts Receivable Deposit
Number Amount
UN Assessment fee for Candidate - Mitchell Harding 001-0000-369.90-00 57.73
Revised: 9/06/07 •JJ01-e: . r
0 \City Clerk\intemal use\DONNAMELECTION 2013\Offsite Cash Receipts for Qualifying\[Copy of 0ffSe Payment Foirill44, LH010:11ngids]POrr
I , W
Total Deposit
Cash
ACH
Checks
Money Orders
Total
Open ATLYDIK:
57.73
57.73
57.73
001 0 W107-if,,q900(1
-ILHELL HP6:0111(.,
1:141 LHECV
Trans PP/IJ