Harding- Assessment Fee- 6-19-17 City of Atlantic Beach
Offsite Payment Form
Date prepared: 06/19/17
Deposit Date: (/r9 I ii
Prepared by: Donna Bartle
Payment Cash GL Account or
Type Receipt Accounts Receivable Deposit
Code Number Description Number Amount
UN Assessment fee for Candidate-M.Harding 001-0000-369.90-00 59.01
Total Deposit 59.01
Cash
ACH
Checks 59.01
Money Orders
Total 59.01
•
Oper: ATLBCCT Type: OC Drawer: 1
Date: 5/19/17 00 Receipt no: 64166
Revised: 9/06/07 UN NON-SPECIFIC
O:\City Clerk\INTERNAL USE\ELECTIONS 20171For Qualifying\[Copy of Offsite Payment Form-M.Harding.xls]Form 1.00 $59.01
00100003699000
HARDING - ASSESSMENT FEE
CK CHECK 1001 $59.01
Trans date: 6/19/17 Time: 12:14:11