Anderson, Tim- Assessment Fee ReceiptDate prepared:
Deposit Date:
Prepared by:
Payment Cash
Type Receipt
Code Number
City of Atlantic Beach
Offsite Payment Form
06/18/13
06/18/13
Donna Bartle
Description
Received
JUN 1 8 2013
Office of City Clerk
GL Account or
Accounts Receivable Deposit
Number Amount
UN Assessment fee for Candidate - Tim Anderson 001-0000-369.90-00 57.73
Total Deposit
Cash
ACH
Checks
Money Orders
Total
57.73
57.73
57.73
Revised: 9/06/07
O:\City Clerk\intemal use\DONNAS\ELECTION 2013\Offsite Cash Receipts for Qualifying\(Copy of Offsite Payment Form -T. Anderson.xls)Fo