244340 04/15/15 CITY OF CARMEL, INDIANA VENDOR: 369278
s ;• ONE CIVIC SQUARE AFSHA SHEIKH CHECK AMOUNT: $********30.00.*
?q; CARMEL, INDIANA 46032 3464 N GOLDEN GATE DR CHECK NUMBER: 244340
M,��ON-�o• WESTFIELD IN 46074 CHECK DATE: 04/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 1430244 30.00 REFUNDS AWARDS & INDE
a ACTIVITY REFUND RECEIPT
I
Carmel �? Receipt# 1430244
� � Payment Date: 04/07/15/15
Parks&Recreation Household#: 58871
Smoky Row Elementary Afsha Sheikh
900 West 136th Street �'�TN TSD 3464 North Golden Garte Drive
Carmel IN 46032 Westfield IN 46074 Cell Ph:(850)570-9060
Phone: (317)848-7275
APR 0.8 2015 afshas1@gmail.com
Fed Tax ID#35-6000972
Refund Details
Orio Bal Refund New Bal
Module: Activity Registration 30.00- 30.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 30.00
Processed on 04/07/15 @ 11:50:13 by AEB NEW REFUND AMOUNT(-) 30.00
TOTAL REFUNDABLE AMOUNT 30.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 30.00 Made By==>REFUND FINAN With Reference=_>
All refunds are subject to Sta and of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issu f
41-1
I�
o zed Signatur Dae Authorized Signature Date
Escape Day Passes are non-refundable. I/ n V- � ,
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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.
Sheikh, Afsha Terms
3464 North Golden Gate Drive Date Due ' _
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/7/15 1430244 Refund $ 30.00
Total $ 30.00
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
120
Clerk-Treasurer
L
Voucher No. Warrant No.
Sheikh,Afsha Allowed 20
3464 North Golden Gate Drive
Westfield, IN 46074
�In Sum of$
$.. ._. _30.00 t
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
CCT#/TITL AMOUNT Board Members
PO#or INVOICE NO. A
Dept#
1081-99 .1430244- 4358400 $ 30.00 1 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
April 21 2015
f Signature
$ 30.0-0 Accounts Payable Coordinator
Cost distribution ledger classification if j Title
claim paid motor vehicle highway fund
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