244575 04/21/15 4�ul..rr�q�F
�! tl CITY OF CARMEL, INDIANA VENDOR: 369278 ».«»«»»« «
;; ONE CIVIC SQUARE AFSHA SHEIKH CHECK AMOUNT: $ 45.00
: CARMEL, INDIANA 46032 3464 N GOLDEN GATE DR CHECK NUMBER: 244575
'M��TON��` WESTFIELD IN 46074 CHECK DATE: 04/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 1431089 45.00 REFUNDS AWARDS & INDE
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ACTIVITY REFUND RECEIPT
T r-�,�1
�`� �"�_ Receipt# 1431089
� � clad Payment Date: 04/10/15
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APR 1 3 2015 l Household#: 58871
ParksAtcreation
BY
Smoky Row Elementary Afsha Sheikh
900 West 136th Street 3464 North Golden Garte Drive
Carmel IN 46032 Westfield IN 46074 Cell Ph:(850)570-9060
afshasl@gmail.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Refund Details
Orio Bal Refund New Bal
Module: Activity Registration 45.00- 45.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 45.00
Processed on 04/10/15 @ 07:22:06 by AEB 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=_>
All refuns are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
Issued
uSignature Date Authorized Signature Date
Escape Day Passes are non-refundable.
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BEST
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
4/10/15 1431089 Refund $ 45.00
Total $ 45.00
1 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
I -
Voucher No. Warrant No. j
Sheikh, Afsha Allowed 20
3464 North Golden Gate Drive
Westfield, IN 46074
In Sum of$
$ 45.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-99 1431089 4358400 $ 45.00 ! 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
i
April 16, 2015
f'
Signature
$ 45_.00_ Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highWayfund