312490 06/13/17 CITY OF CARMEL, INDIANA VENDOR: 241253
t` CHECK AMOUNT: S"""'""""77 20"
ONE CIVIC SQUARE PETTY CASH
4 CARMEL, INDIANA 46032 ciD Docs CHECK NUMBER: 312490
w„o� CHECK DATE: 06/13/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4239099 DOCS 77.20 OTHER MISCELLANOUS
0 n n -0 < <
$ m y O O O m O
n co co co co co co Z p p p c
N N N N N N O O n
on c N
0_ JhL
N z _ c Q
m t c � O O w
m j _
A CT W O N co n 0
O
H W CT W
y N O W W C 4
V
=� 3 D V
3 iv
1:3 N N N N 11 n :► O
O C
W O O O O CL "0 TOO OO
G CD
ww ccoo ccoo tp ccoo z
Z
c N O �
Z
o
< D -n 0
ift_ o O
A O N W A -� C M I
S O O O co N (c)
co
S
CS d N fn r
7 S �_ � Q c C
5L Ol V1 .< <
x N 0 fi - O
(D (D ..
\
CL N z C
CD
_ C- �' a 5
m 3
o m m m
C W d
S a w a N cD =r _
O N N Q o
CL N < N
V N j .d. C a
CL 0 Er p
C
> 'O
CL cD
J
CL cr
�< N N N m
U) VVvV -4 -4
d o Q
3 � s D
o ^
? 3 c `0 N
n om" O N T Z '"
o V Zo N a O
Ad N O O LTIW 0 0 0 - O N O C m N $ c s,
N ' 0 C13 -4 W' C ' co N ' O W m Z D
fm N W N K
S =
O
O D
� N
obi obi
o -n .<
L W D
90 _ 3 a ; 0 "
s c o m n D
o Z a, sC
m n $ m
D o °' s //
-y 3 co C0 6 o < c z \
n s o s r O
m 0 a a � � z m y � � � �c
C 0 = �
CL
a -nm
m
d z N
o D o
� m �
N df N di 40 fA w O
< O N W A CT C
O O O t0 N /00 CR
m
Indiana Payment Portal Page 1 of 1
Your transaction is complete
Your transaction is complete. Print this receipt for your records. Your receipt identification number
is 24283230. Please reference this number in any correspondence regarding your transaction.
Payer Information?
ROSS PIETRZAK
700 ST. MARY'S AVE
APT. 3138
FRANKFORT, IN 46041
Phone : 708 - 308 - 2187
Email : rpietrzak28@gmail.com
Account Information?
4***********8149 exp. 08/19
Transaction Details
Unit Extended
Description Price Quantity 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
553 ,
43 0a
https:Hsecure.in.gov/apps/kwikekard/checkout/servlet/receipt?token=48831 E2174D617D3... 2/14/2017
5E569i�0 qy:4 LIIVZ/90
Illilllllllllllllllilllllllllllllllll �
II
Capitol Commons
BLOLgSA .anon oq **CASH 12** 05/24/17
suLuanlaa aao�aq suo�gegsApd DATE: 02:32 PM
aq le pied eiv s1alloLl TIME:
* Original
Receipt No• 469535211
Ticket -
LPR = 74792 22.00
3d3H 93A0I1S
TAX included 11:44 AN
Valid-
Entry- 05/24)11 02:32 PM
*0 A8lN3**
SUOM 103101103
ZOL :d'1
IIII II III II
III I III I III III III II II IIII III
5E969v0wW 4 LLIOZ/90
Cpu
.�3o • D3
d •99 ■■■
OXIDO TMDate: 06/09/2017
Public Records at Your Fingertips RECEIPT
Receipt#: 645453
822 E.Main St.
Richmond,IN 47374
Account Number: 413247
Received From: Reference Number: 222610355830
Nathan Chavez Payment Type: Credit Card
null
null,null null CC Reference Number: 272374
Payment Amount: $10.00
Amount
Unapplied Amount $10. 0
Total Paid: $10.00
Thank you for your business!
y
My Orders Page 1 of 3
Free shipping on all orders within the US' )(
Wy
pp g
ZAGG O A
� a
ti
MY ACCOUNT MY ORDERS
ACCOUNT Please allow up to fifteen minutes for new orders or registered products to
DASHBOARD appear in Order History.
ACCOUNT ------------- -- - ----- -
INFORMATION Orders
s
ADDRESS BOOK DATE OF PURCHASE ORDER STATUS INVOICE
MY ORDERS DEC 14TH, 2016 > NEW ORDER IR17649733
JUN 23RD, 2015 > OFFSITE OS68524351KP i
I Want to register a j----- --------------------- --— —i
X
product?Only registered
products are covered by Order Invoice IR17649733 j
the warranty.
i
I
DATE OF PURCHASE DEC 14TH,2016
Register a Product ,)�
ORDER STATUS NEW ORDER l�
ORDER SUBTOTAL $0.00
ORDER TAX $0.00 1
Need help with the
replacement process? ORDER TOTAL(ORDER
View our step-by-step SUBTOTAL+ORDER TAX)
guide. SHIPPING COST(IF
APPLICABLE) $5.99
View Replacement Guide SHIPPING METHOD(IF USPS FIRST CLASS
APPLICABLE)
BILLING ADDRESS(IF 14382 WHISPER WIND DRIVE CARMEL IN 46032
APPLICABLE) US
Want to know more about SHIPPING ADDRESS(IF 14382 WHISPER WIND DRIVE CARMEL IN 46032
The Earbud Tips for APPLICABLE) US
Life TM' program? TRACKING NUMBER NA
PRODUCTS PURCHASED 1
Learn More
INVISIBLESHIELD GLASS FOR THE APPLE
PRODUCT PURCHASED
-- - ------ ---- -- -.- IPHONE 6/6S(CASE FRIENDLY)
PRICE PER PRODUCT $34.99 ^^
PRODUCT QTY 1
PRODUCT SKU Z341P6OWC-FOC
https://www.zagg.com/us/en_us/sales/order/history/ 12/14/2016