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Lagner - Assessment Fee - 8-30-22 City of Atlantic Beach Offsite Payment Form Date prepared: 08/29/22 Deposit Date: 08/30/22 Prepared by: Donna Bartle Payment Cash GL Account or Type Receipt Accounts Receivable Deposit Code Number Description Number Amount UN Assessment fee for Candidate-Jennifer Lagner 001-0000-369.90-00 64.95 Total Deposit 64.95 Cash ACH Checks 64.95 Money Orders Total 64.95 • Oper: ATLONRP Type: OC Drawer: 1 Revised: 9/06/07 Date: 8/30/23 00 Receipt no: 88719 NON-SPECIFIC O:\City Clerk\INTERNAL USE\DONNAS\ELECTION 2022\Qualifying Paperwork\[Payment Form-Jennifer Lagner.xis]Form 1.00 $64.95 00100003699000 ASSESSMENT FEE FOR CANDID CK CHECK: 101 $64.95 Trans date: 8/30/22 Time: 8:16:48