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7/7/23, 9:10 AM KUBRA i-Doxs VBS <br />Confirmation & Receipt <br />What You Paid <br />Success! You have paid for all the items listed below. Your forms have been filed with the corresponding City/Cities shown. <br />Thank you for using FileLocal! The total payment will appear as multiple transactions paid to the appropriate Cities and FileLocal on <br />your bank or credit card statement. The Amount Due for each form will be deposited to the appropriate City, and the non- <br />refundable User Fee(s) will be deposited to FileLocal. The non-refundable KUBRA service fee for processing the transaction has <br />been added as shown below and will be retained by the payment processor, KUBRA. <br />An email confirmation will be sent to you by FileLocal. You may print this screen as your receipt, if desired. When finished, click <br />[Return to FileLocal]. You will be able to view and print each form from the FileLocal website, if needed. <br />Form Name <br />Bellevue FileLocal User Fee ($4.00 per City Paid) <br />Bellevue GBL Application "Applied For" <br />KUBRA-Bellevue Service Fee <br />Everett FileLocal User Fee ($4.00 per City Paid) <br />Everett GBL Application "Applied For" <br />KUBRA-Everett Service Fee <br />Lake Forest FileLocal User Fee ($4.00 per City Paid) <br />Park <br />Lake Forest Park GBL Application "Applied For" <br />KUBRA-Lake Forest Park Service Fee <br />Shoreline FileLocal User Fee ($4.00 per City Paid) <br />Shoreline GBL Application "Applied For" <br />KUBRA-Shoreline Service Fee <br />FileLocal <br />FileLocal User Fee ($4.00 per City Paid) <br />Amount Due <br />Filing Period <br />Amount Due <br />Payment Conf. # <br />Jul 2023 <br />$109.00 <br />18843772164 <br />non-refundable <br />$1.00 <br />18843772946 <br />Jul 2023 <br />$50.00 <br />18843773617 <br />non-refundable <br />$1.00 <br />18843774164 <br />Jul 2023 <br />$80.00 <br />18843774399 <br />non-refundable <br />$1.00 <br />18843774649 <br />Jul 2023 <br />$20.00 <br />18843774899 <br />non-refundable <br />$1.00 <br />18843775117 <br />non-refundable <br />$16.00 <br />18843771602 <br />$Z79.00 <br />Note: The Payment Confirmation Number indicates that your payment was successfully authorized. Note that you may have more <br />than one Payment Confirmation Number per City if that City separates funds into different receiving accounts. <br />How You Paid <br />KUBRA Service Fee: <br />Payment Amount <br />Account Type: <br />Account Holder Name: <br />$4.00 non-refundable <br />$279.00 <br />Checking <br />Prado Electric LLC <br />Routing Transit Number: 323371076 <br />Bank Account Number: ************5010 <br />https://secure8.i-doxs.net/FILELOCAL/OneTimeAdd.aspx 1 /1 <br />