Request for Authorized Receipt of Parking Purchases
Please complete the following to receive an authorized receipt for any purchase(s)
made for parking in the Leland Federal Garage located at 2001 Louisiana, Houston, TX, 77002
Today"s Date:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parking Space Number
*
Name:
*
Email Adress :
*
Amount of Payment
*
Payment was Applied to the Month of:
*
Please Select
Jan.
Feb.
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sept.
Oct.
Nov.
Dec.
Add another?
*
Yes
No
Type of Payment
*
Please Select
Check
Money Order
Online Credit Card
Telephone Credit Card
Amount of Payment
Payment was Applied to the Month of:
Please Select
Jan.
Feb.
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sept.
Oct.
Nov.
Dec.
Add another?
Yes
No
Type of Payment
Please Select
Check
Money Order
Online Credit Card
Telephone Credit Card
Amount of Payment
Payment was Applied to the Month of:
Please Select
Jan.
Feb.
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sept.
Oct.
Nov.
Dec.
Add another?
Yes
No
Type of Payment
Please Select
Check
Money Order
Online Credit Card
Telephone Credit Card
Amount of Payment
Payment was Applied to the Month of:
Please Select
Jan.
Feb.
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sept.
Oct.
Nov.
Dec.
Add another?
Yes
No
Type of Payment
Please Select
Check
Money Order
Online Credit Card
Telephone Credit Card
Amount of Payment
Payment was Applied to the Month of:
Please Select
Jan.
Feb.
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sept.
Oct.
Nov.
Dec.
Add another?
Yes
No
Type of Payment
Please Select
Check
Money Order
Online Credit Card
Telephone Credit Card
Amount of Payment
Payment was Applied to the Month of:
Please Select
Jan.
Feb.
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sept.
Oct.
Nov.
Dec.
Add another?
Yes
No
Type of Payment
Please Select
Check
Money Order
Online Credit Card
Telephone Credit Card
Amount of Payment
Payment was Applied to the Month of:
Please Select
Jan.
Feb.
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sept.
Oct.
Nov.
Dec.
Add another?
Yes
No
Type of Payment
Please Select
Check
Money Order
Online Credit Card
Telephone Credit Card
Amount of Payment
Payment was Applied to the Month of:
Please Select
Jan.
Feb.
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sept.
Oct.
Nov.
Dec.
Add another?
*
Yes
No
Type of Payment
Please Select
Check
Money Order
Online Credit Card
Telephone Credit Card
Amount of Payment
Payment was Applied to the Month of:
Please Select
Jan.
Feb.
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sept.
Oct.
Nov.
Dec.
Add another?
Yes
No
Type of Payment
Please Select
Check
Money Order
Online Credit Card
Telephone Credit Card
Amount of Payment
Payment was Applied to the Month of:
Please Select
Jan.
Feb.
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sept.
Oct.
Nov.
Dec.
Add another?
Yes
No
Type of Payment
Please Select
Check
Money Order
Online Credit Card
Telephone Credit Card
Amount of Payment
Payment was Applied to the Month of:
Please Select
Jan.
Feb.
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sept.
Oct.
Nov.
Dec.
Note:
If a receipt for additional payments is required beyond the ones detailed above, you will need to submit an additional form.
Type of Payment
Please Select
Check
Money Order
Online Credit Card
Telephone Credit Card
Submit
Should be Empty: