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305846 12/12/16
VENDOR: 363050 CHECK AMOUNT: $"""""'11.22" �`'�c�,,,• CITY OF CARMEL, INDIANA AMANDA BENNETT CHECK NUMBER: 305846 J` �� ONE CIVIC SQUARE 510 N RILEY AV CHECK DATE: 12112/16 1 CARMEL, INDIANA 46032 INDPLS IN 46201 s�""��M +o AMOUNT DESCRIPTION DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER L.L.Z/- 4.5 2 OTHER PROFESSIONAL FE 1180 4341999 120516 6 > « / q � O B o � O 2 2 / 0 j 2> cn m Q � > 2 . / q z m q \ , Z / / O 2 Q % \ § (D --I --i / a k to ] D \ \ k . / t 2 > Q \ \ CL / q 3 % # T ® CL 0 z 0 E > - • ( ^ 0 | E m ¢ § --I = 2 > ) § \ § 9 Ir- m 0 4 c 0 k A g E/ $0 i 0 m 0 a ; / p \ f - _ f 0 2 7 k ) + - E ( ] % } G k E 0 C k \ R k S' E CL a - 2 . G a § ( ° E CD E � o [ , - c t %£ Q k% \ m \®© - CD CD kk i E \ f¥ ) / g � [ -n a ° 0 E R - § k9 # 0 g g� ° meq ƒ C a $ f C) Z » ) / ° « Q £« § \ / rr | \} % CD _0 eo \ { \ G ° E ) q ( q > e \ \ 2 0 \ / PD } 0 CD c \ i 0 . ? 7 / \ / cr C: 3 » c a % $ & n G § 2 0 \ § M } CD 0 \ ] § © F . > i 0 \ E CD CD _ 0 . { § / \ 11/28/2016 Indiana Payment Portal Your transaction is complete Your transaction is complete. Print this receipt for your records. Your receipt identification number is 23910326. Please reference this number in any correspondence regarding your transaction. Payer Information ? AMANDA BENNETT Phone Email Account Information ? 4*********** exp. 10/18 Transaction Details Description Unit Price QuanExtendedtity Price Notary Application Fee $10.00 1 $10.00 Instant Access Fee $1.22 1 $1.22 Total ., $11.22 The following amounts have been charged to your credit card. Your credit card statement will show the following merchant name(s) and amount(s) for this transaction. Merchant Amount IN Sec of State 800-236-5446 $11.22 The total amount charged to your credit card is $11.22. Privacy Statement https://secure.in.gov/apps/kwikekardtcheckouttservlettreceipt?token=4263D7D256EA2DO9EO54002128l49A9E v�