Glasser- Assessment Fee- 6-20-17City of Atlantic Beach
Offsite Payment Form
Date prepared: 06/19/17
Deposit Date:
Prepared by: Donna Bartle
Payment Cash GL Account or
Type Receipt Accounts Receivable Deposit
Code Number Description Number Amount
UN Assessment fee for Candidate-Ellen Glasser 001-0000-369.90-00 96.96
Total Deposit 96.96
Cash
ACH
Checks 96.96
Money Orders
Total 96.96
Oper: ATLBCCT Type: OC Drawer: 1
Revised: 9/06/07 Date: 6/20/17 00 Receipt no: 64655
O:1City Clerk\INTERNAL USEIELECTIONS 20171For Quali in 1 Co y of Offsite Payment Form-Ellen Glasser.xls]Fomi NON-SPECIFIC9[ P 1.00 96.96
00100003699000
GLASSER - ASSESSMENT FEE
CK CHECK 1074 96.96
Trans date: 6/20/17 Time: 11:13:57