246545 06/17/15 CITY OF CARMEL, INDIANA VENDOR: 369474 CHECK AMOUNT: S********38.00*
(9,
ONE CIVIC SQUARE TAMARA STEVENSON
CARMEL, INDIANA 46032 1301ST ST NE CHECK NUMBER: 246545
CHECK DATE: 06/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 4005607931 38.00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt#. 1451173 ..... AV
Payment Date: 06/09/2015ks
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Household#: 29094 rr<e.
r ' Eon
Home Phone: (317)372-5980
TAMARA STEVENSON Monon Community Center
130 1ST ST. NE _ —; — --- Carmel IN 46032
CARMEL IN 46032 `-�. - ''
JUN 2015 Phone: (317)848-7275
I Fed Tax ID#35-6000972
nn __ -I- __ -- J
Pass Details
CANCELLATION -Refund Of 38.00
Pass Holder: Tamara Bangert Fees+Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: MCorp Adlt Mty(M CPAM),#273724 86.00 0.00 86.00 0.00 0.00
Valid Dates: 02/04/2015 to 02/04/2016 (Pass Cancellation)
Cancellation Effective: 06/09/2015
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
nCorp Monthly Pass 86.00 1.00 0.00 0.00 86.00
Cancel Reason: double billed
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 06/09/15 @ 13:52:41 by KHOBLIK FEES CHANGED ON CANCELLED ITEMS(+) 38.00-
DISCOUNT APPLIED AGAINST CANCELLED FEES(-) 0.00
SALES TAX CHARGED ON CANCELLED FEES(+) .0.00
NET AMOUNT FROM CANCELLED ITEMS
TOTAL AMOUNT AMOUNT REFUNDED 38.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 38.00 Made By=_>REFUND FINAN With Reference=_>
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 Signature Date Authorized Signature Date
oq I. ��5 Ett 00
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.
Stevenson, Tamara Terms
130 1st St NE Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/9/15 1451173 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 I C 5-11-10-1.6
20_
Clerk-Treasurer
i
i
Voucher No. Warrant No.
Stevenson, Tamara Allowed 20
130 1st St NE
Carmel, IN 46032
1 Sum of$
$ 38.00 I
f
ON ACCOUNT OF APPROPRIATION FOR i
109 -MCC
I
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1092 1451173 4358400 $ 38.00 I;hereby certify that the attached invoice(s), or
i
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
June 12, 2015
i
Signature
$ 38.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I
I