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2642 Madison "-"': ~ \1\2"05 CITY OF ANAHEIM FINANCE DEPARTMENT COLLECTIONS OFFICIAL RECEIPT/DEPOSIT RECEIVED FROM: 'R' ~.~~l+ ~~P6~D Bt ~h-~iQ~~~tb.~(PD.- ~~~ '.. '-COR Prepared By: 5~t5 i 14, PIC OBJ 4 SBSA REV SRC APPR UNIT FUNC 4 4 9 10 o BSA 4 Nt? 172929 Deposit Breakdown: CHECK (5): . QTY _ AMOUNT: CURRENCY: 100'sx_= 50'sx_= 20'sx_= 10'5)(_= 5'5)(_= 1'5)(_= Coin Total: Currency Total: iieg~;~gBT€g." , - TOTAL: $ 5?J...(P. .. .' ,. Distribution: White. Acctg Yellow - Customer Pink - Reconcile Copy Goldenrod -Originatin{JDept. ....Please Do Not Write Below This Line.... Area Used for Cashier Validiltion . RECEIVED G;;9 20n~] BUILDING OI\lISION D~te: It/i:!2nJS:55 V:l:t:ei})t m)~Jt.li?li3 HI mscHtAi'IE!}l!S 1 166~.eg 2mI2r72" .Jim @019 '. Ml mSC:Elllilif DUg 218412f124 1&18 i45E,S.(j\~ Total t.~lld~"f"~d $5E2&.€itj hlel p;rl'~ill $5226.8\1 Tr,,,,. d~te: !l/22/0j H',e, H:46,.37 COl.18 Rev. 6/05