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6/18/2019 • KUBRA i-Doxs VBS <br /> • <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 Filing Period Amount Due Payment Coof. # <br /> Name <br /> Everett FileLocal User Fee ($4.00 per City Paid) <br /> Everett GBL Application "Applied For" Jun 2019 $83.00 16948867379 <br /> KUBRA-Everett Convenience Fee non-refundable $1.00 16948867488 <br /> FileLocal <br /> FileLocal User Fee ($4.00 per City Paid) non-refundable $4.00 16948866864 <br /> Amount Due $81, <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: $1.00 non-refundable <br /> Payment Amount: $88.00 <br /> Account Type: Checking <br /> Account Holder Name: SK ELECTRIC LLC <br /> Routing Transit Number: 325081403 <br /> Bank Account Number: ************5771 <br /> https://secure8.i-doxs.net/FILELOCAL/OneTinneAdd.aspx 1/1 <br />