5 10th ST - RECEIPT O:' Ts Cash Register Receipt Receipt Number
v . - i
City of Atlantic Beach R3522
'hr a 1— -- -- - - - --- -------J
DESCRIPTION •
ACCOUNT I QTY I PAID
PermitTRAK $55.00
RES17-0202 Address: 5 10TH ST APN: 170263 0100 $55.00
- WINDOW DOOR FINAL 11/21/2017 RBE $55.00
WINDOW DOOR FINAL 11/21/2017 RBE 45500003221002 0 $55.00
TOTAL FEES PAID BY RECEIPT: R3522 $55.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
11/27/2017 10:49:08
CREDIT CARD
VISA SALE
Card# XXX)O0000000(8068
SEQ#: 4
Batch#: 490
INVOICE 4
Approval Code: 05701G
Entry Method: Manual
Mode: Online
Tax Amount: $0,00
Card Code: M
' SALE AMOUNT $55,00
CUSTOMER COPY
Date Paid: Monday, November 27, 2017
Paid By: MARTIN HOME EXTERIORS
Cashier: BA
Pay Method: CREDIT CARD 4
11
Printed: Monday, November 27,2017 10:51 AM 1 of 1 A