HomeMy WebLinkAbout06-24-2026 - Payment Received FormCITY OF RENTON
REVENUE/CHECK DOCUMENTATION FORM
Instructions: Use this form to document miscellaneous checks and cash received by the city (i.e. reimbursement of personal charges
on city credit card, insurance claims, etc.) Supportive documentation must be attached prior to processing.
DATE:
PHONE NUMBER/EXT:
AMOUNT:
SOURCE (who from):
Account Number Amount
Account Number Amount
Account Number Amount
Account Number Amount
Account Number Amount
Account Number Amount
Account Number Amount
Account Number Amount
RECEIPT CREDIT CARD STATEMENT CHECK STUB OTHER:
SIGNATURE:
SUBMITTING DEPT.
EMPLOYEE NAME
DETAILED TRANSACTION DESCRIPTION
ACCOUNT NUMBER (GL FORMAT XXX.XXXXXX.XXX.XXX.XX.XX.XXX)
DOCUMENTATION TYPE
6/24/2026
ASD - City Clerk
6502
Jason Seth600.00
George & Heather Brewer
000.000000.005.369.91.00.018
Street Vacation - Brewer (NE 4th St. E and Lyons Av NE) - VAC-26-002
600.00
Stre St. sE and Lyons Av NE) - VAC-26-002