Kelly - 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-Candace Kelly 001-0000-369.90-00 64.95
Total Deposit 64.95
Cash
ACH
Checks 64.95
Money Orders
Total 64.95
•
Oper: ATLENRP Type: OC Drawer: 1
Date: 8/30/22 00 Receipt no: 89378
Revised: 9/06/07 UN NON-SPECIFIiC
O:\City Clerk\INTERNAL USE\DONNAs\ELECTION 2022\Qualifying Paperwork\[Payment Form-Candace Kelly.xls]Form 1.00 $64.95
0010000699000
ASSESSMENT FEE FOR CANDID
EN CHECK 99 $64.95
Trans date: 8/30/22 Time: 15:18:26