242789 03/03/15 .4+u1.F!Igy�f
CITY OF CARMEL, INDIANA VENDOR: 369153
® i ONE CIVIC SQUARE MEHERNAAZ MATHUR CHECK AMOUNT: $********45.00*
CARMEL, INDIANA 46032 14258 CHARIOTS WHISPER DR CHECK NUMBER: 242789
9d/iroii.c�. WESTFIELD IN 46074 CHECK DATE: 03/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 1412693 45.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1412693
Carmel a Clay Payment Date: 02/24/15
Pa
rksecrion N rf::i�D Household#: 17550
FEB 2 5 2015
Smoky Row Elementary Mehernaaz Mathur Hm Ph: 317 818-1801
900 West 136th Street °J' _---- 14258 Chariots Whisper Dr. ( )
Carmel IN 46032 Westfield IN 46074 Cell Ph:
Phone: (317)848-7275 mehernaazmathur@gmail.com
Fed Tax ID#35-6000972
Refund Details
Orin Bal Refund New Bal
Module: Activity Registration 45.00- 45.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 45.00
Processed on 02/24/15 @ 07:27:58 by LKW NEW REFUND AMOUNT(-) 45.00
TOTAL REFUNDABLE AMOUNT 45.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 45.00 Made By=_>REFUND FINAN With Reference 143 Q Q
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
iss
P.ut zed Signa ure Date Authorized Signature Date
Escape Day Passes are non-refundable.
Page# 1 of 1
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service,where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Mathur, Mehernaaz Terms
14258 Chariots Whisper Dr Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/24/15 1412693 Refund $ 45.00
Total $ 45.00
I hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
20_
Clerk-Treasurer
Voucher No. Warrant No.
Mathur, Mehernaaz Allowed 20
1.4258 Chariots Whisper Or
Westfield, IN 46074
In Sum of$
$ 45.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE ), .
I
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-99 1412693 4358400 $ 45.00 til hereby certify that the attached invoice(s), or
'bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
(received except
f
I;
I,
February 26,2015
i
i, Signature
$ 45.00 , Accounts Payable,Coordinator
Cost distribution ledger classification if ), Title -
claim paid motor vehicle highway fund
I�
t.