242250 02/17/15 V CITY OF CARMEL, INDIANA VENDOR: 369108
ONE CIVIC SQUARE DAWN DYER CHECK AMOUNT: S..'"""'89.00"
CARMEL, INDIANA 46032 13926 LEATHERWOOD DR CHECK NUMBER: 242250
CARMEL IN 46033 CHECK DATE: 02/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 1404815 89.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1404815
Carmel @ Gley Payment Date: 02/12/15
Household #: 34733
Parks&Recreation
Monon Community Center '� Dawn Dyer Hm Ph: (317)569-8612
Carmel IN 46032 FEB 12 2015 13926 Leatherwood Drive Wk Ph: (317)569-8612
Carmel IN 46033 Cell Ph:(317)385-2994
Phone: (317)848-7275 BY:_ dmdyer1969@yahoo.com
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 89.00- 89.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 89.00
Processed on 02/12/15 @ 10:29:26 by JAB NEW REFUND AMOUNT(-) 89.00
TOTAL REFUNDABLE AMOUNT 89.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 89.00 Made By==>REFUND FINAN With Reference=_>parent request;81-99-4358400 refund
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
zed 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.
Dyer, Dawn Terms
13926 Leatherwood Drive Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2112115 1404815 Refund $ 89.00
Total $ 89.00
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.
Dyer, Dawn Allowed 20
13926 Leatherwood Drive
Carmel, IN 46033
In Sum of$
$ 89.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-99 1404815 4358400 $ 89.00 I hereby 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
February 12, 2015
Signature
$ 89.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund