City of Los Angeles
Bureau of Engineering
BOE - Central District
Transaction ID: 2021021418
(Paid)
Print Receipt
| Description | Qty@Price | SubT |
|---|---|---|
| ENG PROC FEE-ALL OTHERS | 1.00@$129.00 | $129.00 |
| Subtotal | $129.00 | |
| Grand Total | $129.00 | |
| Tendered | $129.00 | |
| Balance | $0.00 | |
Reference: ENG FEE 20010-10000-03856
ACH Payment(s)
| Date | 10/18/2021 12:46:30 PM |
| Routing No. | ******496 |
| Account No. | ************6719 |
| Type | SALE |
| Status |
APPROVAL |
| Amount | $129.00 |
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 ************6719 and routing number of ******496 or to process the payment as a check transaction or bank drawn draft from my account for the amount of $129.00.
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.
