pool receipt City of Atlantic Beach, Florida
cardknox 800 Seminole Rd
A Fidelity Payments Company
Atlantic Beach FL 32233
904-247-5800
PROCESSING INFORMATION
Amount $127.50
10/21/2021 10:36:23 AM
Sale
Approved
CARD INFORMATION
Visa Card expiration: 02/23
"""7563 Cardholder name:
BILLING INFORMATION
IN
Building-Dept@coab.us
ADDITIONAL INFORMATION
Entry method. Keyed Reference Number: 534810835
Payment type: Credit Card Authorization Code: 56890D
AVS: Custom 01:
Address: No Match&5 Digit ZIP: No Match
Custom 02:_ Custom 03:
Servi e Fee: $3.6
Description:
POOL21-0038
SIGNAT R
X
I Agree to pay above total arr cording to card issuer agreement period.