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<br />~~) <br /> <br /> <br />I <br />.. . <br /> <br />STATIO' 'LORIDA <br /> <br />City of Zephyrhills <br />I <br />: PASCO COUNTY <br /> <br />DISBURSEMENT REQUEST. REFUNDS & MISCELLANEOUS PAYMENTS <br /> <br />J'- / SI'- y,-/ <br />. <br /> <br />DATE <br /> <br />TO: ACCOUNTING <br /> <br />FROM: <br /> <br />AJL' <br /> <br />(De~n'ment) <br /> <br />;:$ <br />AMOUNT: ~ 7- -..S().. <br />PAYABLETO:~J~ )JJ~ <br />0/cl.7 ~~ _ <br /> <br />- <br /> <br /> <br />~ ,;..u. J.ss'Yo <br /> <br />VENDOR II: <br /> <br />REASON FOR PAYMENT: <br /> <br />~A/4Lr d'YI j:)~~ 37'7{, <br /> <br />g <br /> <br />CHARGETOACCOUNTII 6J/ -3d.~' - 0 0 0 <br /> <br />REQUESTED BY: ~~~;/.Q" <br />(Slg~.J9r.) <br />APPROVED BY: ( ~ <br />(Signature) <br /> <br />ACCOUNTING USE ONLY: <br />Paid Date: <br /> <br />check . <br />