City of Los Angeles
Bureau of Sanitation
BOS - Figueroa Plaza
Transaction ID: 2021030924 (Paid)
Print Receipt
Description Qty@Price SubT
LID - RES, 1 TO 4 UNITS, 500-9999 SF 1.00@$200.00 $200.00
One Stop Surcharge 1.00@$6.00 $6.00
Subtotal $206.00
Grand Total $206.00
Tendered $206.00
Balance $0.00

Reference: 9428 Crebs Ave 21014-20000-01666

ACH Payment(s)

Date 10/18/2021 7:43:58 PM
Routing No. ******627
Account No. ************6447
Type SALE
Status
APPROVAL
Amount $206.00
YOUR CHECK PAYMENT WILL BE PROCESSED AS
A ONE-TIME ACH FUND TRANSFER FROM YOUR BANK ACCOUNT.
I authorize the City of Los Angeles to use the information above to initiate an electronic fund transfer from my bank account with account number ************6447 and routing number of ******627 or to process the payment as a check transaction or bank drawn draft from my account for the amount of $206.00.

If my payment is returned due to insufficient funds, I authorize the City of Los Angeles to make a one‐time electronic funds transfer or to use a bank draft drawn from my account to collect a fee as allowed by state law.


The City reserves the right to issue a partial or full refund for this transaction. To request a refund, applicant has to submit a Claim for Refund.
Note: Some processing fees may not be refundable.

I Agree that I cannot reverse this charge and I agree to use the City's Claim for Refund process to request any refunds.


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