243041 03/11/15 CITY OF CARMEL, INDIANA VENDOR: 369163
9 $""""`"187.00'ONE CIVIC SQUARE THERESA RAMOS CHECK AMOUNT:CARMEL, INDIANA 46032 7372 CHIPWOOD DRIVE CHECK NUMBER: 243041 NOBLESVILLE IN 46062 CHECK DATE: 03/11/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 187.00 PARKS DEPARTMENT REFU
z GLOBAL REFUND RECEIPT
Receipt# 1413970
cf, 'I Clay Payment Date: 02/27/15
r � ��r � s�� Household#: 55487
MAR 0 2 2015
Monon Community Center Theresa Ramos Hm Ph: (219)588-2620
Carmel IN 46032 7372 Chipwood Drive Wk Ph: (317)846-4677
� - Noblesville IN 46062 Cell Ph:(219)588-2620
Phone: (317)848-7275 tbookramos@gmail.com
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 147.00- 147.00 0.00
Module: Pass Management 40.00- 40.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 187.00
Processed on 02/27/15 @ 16:33:01 by BJJ NEW REFUND AMOUNT(-) 187.00
TOTAL REFUNDABLE AMOUNT 487.00'
NEW NET HOUSEHOLD BALANCE 0.00
4flyo-7tl4,6
Refund of=_> 187.00 Made By==>REFUND FINAN With Reference=_>1081-99-4358400 �1 J py�JNl
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
Aut ri 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.
Ramos, Theresa Terms
7372 Chipwood Drive Date Due
Noblesville, IN 46062
Invoice Invoice Description
Date Number .(or note attached invoice(s) or bill(s)) Amount
2/27/15 1413970 Refund $ 147.00
2/27/15 1413970 Refund $ 40.00
Total $ 187.00
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
Voucher No. Warrant No.
Ramos, Theresa Allowed 20
7372 Chipwood Drive
Noblesville, IN 46062
In Sum of$
$ 187.00
i
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-99 1413970 4358400 $ 147.00 1 hereby certify that the attached invoice(s), or
1081-1 1413970 4358400 $ 40.00 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'
March 5, 2015
Signature
$ 187.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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