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Payor / Name of Bussiness Tax Bussiness Marriage Sand & Medical Police Mayors cemetery Ord. No. 11- Registration Secretary's Certification
Date O.R. No. Solemnization Permit Fees Permit Fees TAWAS
Taxpayer TOTAL Code Tax Code Counseling Gravel Fee Clearance Clearance fee Y17 CJ fees fees fees
593-1
7,350.00
1,280.00
25.00
1,000.00
250.00
8,630.00 1,250.00 25.00 -
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C. ACCOUNTABILITY FOR ACCOUNTABLE FORMS
SUB - TOTAL P -
GRAND - TOTAL P Err:509
REPORT OF ACCOUNTABILITTY OF ACCOUNTABLE FORMS
Month of ____________________________ 20________
Certified Correct:
Accountable Officer
Date
Certified Correct:
Accountable Officer
Date