HomeMy WebLinkAbout4-03-06CITY OF SEBASTIAN
FINANCE DEPARTMENT RECEIPT 9 9 7 7
Name 1ss����e� Ja k l� ❑ Cash
Date L' 3 f�Check #
❑ Credit
Amount Paid
001001 208001
Sales Tax
001001 220000
Security Deposit -
001501 362100
Taxable Rent -
001501 362150
Non -Taxable Rent -
450010 369900
Airport Badge
001501 329500
Alarm Permits
001001218010
CobraServe
001501 354100
Code Enforcement Fines
001501 347557
Community Center Revenue
001501341920
Copies
001501 369900
Miscellaneous Revenue
001501 359000
Other Fines/Forfeitures
001501 351140
Parking Citation
001501 342100
Police Security Services
601010 3y3froo
00.00
Uu 83 L64-7
Total Paid W
Initials
White - Dept. of Origin • Yellow - Finance • Pink -
Applicant
MY OF
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HOME OF PELICAN ISLAND
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
W Q 14-P_r Qy1 Cs+ 0 y- YA (A. S-)' YY1_
Name(s)
Address
P
Area Code & Phone Number
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
Dollars ($ 4006. °b )
on this 3 rA day of raj , 20 16 for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
Unit 4 , Block _s�, Lot(s) 6 1" 7 Niche(s)
for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed
therefore by the City of Sebastian.
Additional Fees paid at time of purchase:
Corner Markers (set of 4 - $20) Opening & Closing
Vase and Ring for Niches (cost)
Temporary Marker Preparation & Installatio
Signature of Purchaser
/W O H
Circle One
Interment Disinterme
TOTAL$ g000.o0
4ity�
of Sebastian
The following documents were provided as Proof of
Residency:
I:\WW-DATA\Ms-Cemetery\RECEIPT.doc
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