9-10 Form A.D. FORM 10 TOWN OF DARTMOUTH
SCHEDULE OF DEPARTMENTAL PAYMENTS TO COLLECTOR
Dept. Zoning Board of Appeals Date May 6, 2021
From Whom Source ORG-OBJ# CHARGE Check Cash Total
Dauntless Invest Petitions 01000-44122 44122 760 760.00
RE: 747 State Rd
CK 1005
Postage 01000-43716 43716 13.26 13.26
Total Checks 773.26
Total Cash
Total 773.26
Date May 6, 2021
HM
To the Departmental Officer making the Payment: O.0R
le
Received of Zoning Board of Appeals the sum o
Three Hundred Seventy Three 26/00 Dollars
for the Period ending May 8, 2021 for ' 1(loW��f
I have paic to the Town Collector whose receipts I hold therefore.
f"].1/i eLrc-
Signature of Depart ent Head
Town Collector