115 POINTETTIA ST - OFFSITE PAYMENTDate prepared:
Deposit Date:
Prepared by:
City of Atlantic Beach
Offsite Payment Form
04/28/15
04/28/15
J. WALKER
Payment
Cash
GL Account or
Type
Receipt
Accounts Receivable
Deposit
Code
Number Description
Number
Amount
TR
Permit #1 6-DRTV-1 017
112-0000-366.00-00
1.469.00
PAID CK #1756
Lifestyles Rental Svc Inc
586 MARSHLANDING PARKWAY
Jacksonville Be, FL 32250
1756
W755t2
Pay to'he \ y
Order of —
—n,rs 8
ANIERIS BANK
seas ram ama.rwv 1y —
iac2aomnlo.na2z+ge rlM 1
1,469.00
For C A t
6oO
8556993i1':020 75 1756
I S p o\ th5 Q• 1 1 1 Q. JT
Checks 1,469.00
Marey Orden
Revised: 04119/09
0 TinanceAnanw forms\Offsite Paymentst[Of/site Payment Fonn-Tree Fund.dslTree Fund
Total 1,469.00
Oper: ATLBBJA Type: OC Grauer: I
Gate: 4/29/15 00 Receipt no: 49788
TR TREE MITIGATION DONATIONS
1.00 $1469.00
11200003660000
PERMITf15DRTy-1017
CK CHECK 1756 %1469.00
Trans date: 4/29/15 Time: 9:27:06