241844 02/03/15 %t..c,q\�. CITY OF CARMEL, INDIANA VENDOR: 369075
ONE CIVIC SQUARE MARIA SILK CHECK AMOUNT: $**'***'"38.00`
?� CARMEL, INDIANA 46032 10942 LATONIA LANE CHECK NUMBER: 241844
v,M(TON-�� INDIANAPOLIS IN 46280 CHECK DATE: 02/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 38.00 PARKS DEPARTMENT REFU
PASS REFUND RECEIPT
Receipt# 1397474av
Payment Date: 01/23/2015
Household#: 32941 rkS ` r
T
Home Phone: (317)575-1838 T�aJ�
JAN 2,6 2015
MARIA SILK Monon Community Center
10942 LATONIA LANE Carmel IN 46032
INDIANAPOLIS IN 46280
Phone: (317)848-7275
Fed Tax ID#35-6000972
Pass Details
MEMBERSHIP CHANGE -Refund Of 38.00
Pass Holder: Bryon Silk Fees+Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: MC Adlt Mthly(M MCAM), #95584 385.00 0.00 385.00 0.00 0.00
Valid Dates: 01/18/2014 to 01/17/2015 (Pass Cancellation)
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
nMonthly MC Pass 385.00 1.00 0.00 0.00 385.00
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 01/23/15 @ 06:53:39 by HPG FEES ADJUSTED ON CHANGED ITEMS(+) 38.00-
DISCOUNT APPLIED AGAINST THESE FEES(-) 0.00
SALES TAX CHARGED ON CHANGED FEES(+) 0.00
NET AMOUNT.FROM CHANGED ITEMS 38.00-
TOTAL AMOUNT REFUNDED 38.00
(D / I �5 NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 38.00 Made By=_>REFUND FINAN With Reference=_>guest request ss
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
iss ed.
112y�
Authorizedig ature 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.
Silk, Maria Terms
10942 Latonia Lane Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/23/15 1397474 Refund $ 38.00
Total $ 38.00
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
s
Voucher No. Warrant No.
Silk, Maria All wed 20
10942 Latonia Lane
Indianapolis, IN 46280 !
In1Sum of$
$ 38.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#
Dept
#or Board Members
Dept INVOICE NO. ACCT#/TITLE AMOUNT
1092 1397474 4358400 $ 38.00 1 llereby 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.
f
January 29, 2015
i;
�f
Signature
$ 38.00 ! Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund