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Schedule - Mass. In MotionSheet3 Sheet2 Sheet1 City Of Northampton Schedule of Department Payments to Treasurer To the Department Officer making the Payment: Total A.D. Form 9 No: Amount Amount: Source (Description) ORG-OBJ From Whom Instructions: 2) Enter "Who gave the money to the City" in "From Whom" Received of: For the period ending : For collection as per schedule filed in my office . Date 1) Enter data in blue shaded cells only / the other fields will auto-fill ____________ ___ Prepared by Department by: Approved by Department by : Received by Treasurer by : Department: Date: Auditor Treasurer Department 3) The Department Approved by section is optional. 4) Three copies are needed: One for Treasurer, One for Department and One for Auditor 5) The Department sends the Auditor copy to the Auditor without the Treasurer signature 6) The Treasurer returns a counter-signed photocopy to Department Checks- Cash- Advice of credit- Planning & Sustainability UniPay- Deposit to: Mass. In Motion 2246175-468000 MOTIN Dept. of Public Health Aleta DeLisle 22-MIM-3 2014-01-14 Trsr ?3?/?2?/?2022 12500.00 $12,500.00 12500.00 ?3?/?2?/?2022 12500.00 ?3?/?2?/?2022