240154 12/09/2014 CITY OF CARMEL, INDIANA VENDOR: 368916
ONE CIVIC SQUARE LISA WILSON CHECK AMOUNT: $*******350.00*
CARMEL, INDIANA 46032 1116 BIRNAM WOODS CHECK NUMBER: 240154
MUTON�. INDIANAPOLIS IN 46280 CHECK DATE: 12/09/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 350.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1371801
r M le 1 0 .11 HCl, Payment Date: 11/26/14
Household#: 7088
Monon Community Center Lisa Wilson Hm Ph: (317)569-9799
Carmel IN 46032 1116 Birnam Woods Wk Ph: (317)294-8046
DEC -2 2014 Indianapolis IN 46280 Cell Ph:(317)294-8046
lisafarling@att.net
Phone: (317)848-7275
Fed Tax ID#35-6000972 ` .
Refund Details
Orio Bal Refund New Be[
Module: Activity Registration 350.00- 350.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 350.00
Processed on 11/26/14 @ 11:56:19 by BJJ NEW REFUND AMOUNT(-) 350.00
TOTAL REFUNDABLE AMOUNT 350.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 350.00 Made By==>REFUND FINAN With Reference=_>1082-11-4358400
All refurIAs are subject to State Board of Accounts procedures and may take 4-6 weeks to pr ess. No cash refunds will be
issue
A razed Signature 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.
Wilson, Lisa Terms
1116 Birnam Woods Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/26/14 1371801 Refund $_ 350.00
Totals 350.00
I hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
, 20
Clerk-Treasurer
Voucher No. Warrant No.
Wilson, Lisa Al owed 20
1116 Birnam Woods
Indianapolis, IN 46280
In�,Sum of.$
$ 350.00 �.
ON ACCOUNT OF APPROPRIATION FOR
i
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT I Board Members
Dept#
i
1082-11 1371801 4358400 $ 350.00 If hereby certify that the attached invoice(s), or
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
I
Which charge is made were ordered and
received except
4
i
f
t
3-Dec 2014
j Signature
$ 350.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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