Form 9-10 state rdA.D. FORM 10
SCHEDULE OF DEPARTMENTAL PAYMENTS TO COLLECTOR
From Whom
Walter Smith
RE: 12 Bayview Ave
CK 3147
To the Departmental Officer making the Payment:
Three Hundred Ninety-Seven 10/00
for the
I have paid to the Town Treasurer, whose receipt I hold therefore.
Received of
Period
to the Town Collector whose receipts I hold therefore.
Source
Petitions
Postage
TOWN OF DARTMOUTH
Dept.
Zoning Board of Appeals
Zoning Board of Appeals
ORG-OBJ #
01000-44122
01000-43716
ending
9/11/2021
CHARGE
44122
43716
Date
Check
360
37.1
Total Checks
Total Cash
Total
Date
Signature of Department Head
Town Collector
9/10/2021
9/10/2021
the sum of
Dollars
for
Cash
Total
360
37.1
397.1
397.1