Receipt - 2269 W Oceanforest Dr RESA23-0026CARD INFORMATION
Card type:Visa Card expiration:09/25
Card number:**** 7929 Cardholder name:Geraldine Cuny
BILLING INFORMATION
Geraldine Cuny
8862 Canopy Oaks Dr
Jacksonville FL 32256
building-dept@coab.us
9043479460
ADDITIONAL INFORMATION
Entry method:Keyed Reference Number:10106967929
Payment type:Credit Card Authorization Code:075331
AVS:Address: Match & 5 Digit ZIP: Match Service Fee:$133.45
Description:
RESA23-0026 2269 W OCEANFOREST DR
SIGNATURE
X
I Agree to pay above total amount according to card issuer agreement period.
PROCESSING INFORMATION
Amount $4,617.75
Date:8/29/2023 4:59:59 PM
Transaction type:Sale
Status:Approved
City of Atlantic Beach, Florida
800 Seminole Rd
Atlantic Beach FL 32233
904-247-5800