HomeMy WebLinkAbout235835 08/13/14 (9,
CITY OF CARMEL, INDIANA VENDOR: 368521
CHECK AMOUNT: $********35.00*
ONE CIVIC SQUARE ELIZE FOXCARMEL, INDIANA 46032 10725 N PARK AVE CHECK NUMBER: 235835
INDIANAPOLIS IN 46280 CHECK DATE: 08/13/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 1321341 35.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1321341 - &I " C-,
Payment Date: 08/02/2014 �,tRd
r, � �
Household#: 54405 ,, x . l�
Home Phone: (661)816-5463
AUG - 5 2014
BY:
at
ELIZE FOX Mon on Community Center
10725 N. PARK AVE Carmel IN 46032
INDIANAPOLIS IN 46280
Phone: (317)848-7275
Fed Tax ID#35-6000972
Pass Details
CANCELLATION -Refund Of 35.00
Pass Holder: Elize FOX Fees+Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: MC Adlt Mthly(M MCAM),#210769 0.00 0.00 0.00 0.00 0.00
Valid Dates: 06/22/2014 to 06/21/2015 (Pass Cancellation)
Cancellation Effective: 08/02/2014
Pass Comments:
Cancel Reason: Was Scholarship- Renewed at wrong rate.
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 08/02/14 @ 14:25:42 by MNS FEES CHANGED ON CANCELLED ITEMS(+) 35.00-
DISCOUNT APPLIED AGAINST CANCELLED FEES(-) 0.00
SALES TAX CHARGED ON CANCELLED FEES(+) 0.00
NET AMOUNT FROM CANCELLED ITEMS 35.00-
TOTAL AMOUNT REFUNDED 35.00-
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 35.00 Made By=`>REFUND FINAN With Reference=_>Staff Error
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
Authorized Signa r 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.
Fox, Elize Terms
10725 N Park Ave Date Due
Indianpolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/2/14 1321341 Refund $ 35.00
Total $ 35.00
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
120
Clerk-Treasurer
Voucher No. Warrant No.
Fox, Elize Allowed 20
10725 N Park Ave
Indianpolis, IN 46280
In Sum of$
$ 35.00
i,
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
i
PO#or
Dept
INVOICE NO. ACCT#/TITL AMOUNT j' Board Members
Dept#
1092 1321341 4358400 $ 35.00 1 hereby certify that the attached invoice(s), or
�lbill(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
11-Aug 2014
Signature
$ 35.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund