307016 1/12/17 CITY OF CARMEL, INDIANA VENDOR: 371437 CHECK AMOUNT: $********80.00*
ONE CIVIC SQUARE LYDIA NAYLOR CHECK NUMBER: 307016
CA
CARMEL, INDIANA 46032 9TH ST NW
CARMEL IN asosz CHECK DATE: 01/12/17
DEPARTMENT ACCOUNT PO NUME Ell INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 2000477004 80.00 REFUNDS AWARDS & INDE
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Receipt#2000477.004 Page 1 of 1
JAN 0 5 2017
Monon Community Center N est BY:"""""' ' """"" "" #2000477.004
Building Dec 28, 2016 11:08 AM
1195 Central Park Dr. West
Carmel, IN 46032
Phone: (317) 848-7275
CarFAX: el
-- * Clay
Email: info@carmelclayparkscom
PaFks&ReCFeation
NATIONAL GOLD MEDAL WINNER
AND ACCREDITED AGENCY
Prepared By: mandys
Customer ID: 35883
Primary phone: _ I" }r econdary phone: (317) 232-1836
Refund Summary
($80.00) Check #
Total Received: ($80.00) Total Refund:
Transactions
Customer Description Item Unit Qty Fee Charge
Lydia Naylor Escape Pass-I dult Monthly Membership Each 1.00 $40.00 ($40.00)
141 9th St NW Action: Mernbc Irship Refund Fee
Carmel,IN 46032 Expires: Dec 1-f, 2016
Primary phone:(317)232- Pass # 130038 90: Lydia Naylor
1836 Thanks for you purchase!This pass will
Email:cwnaylor@hotmail.com automatically r new each month, until cancellation
ID:35883 request is received. Cancellation request must be
received 7 clays prior to billing date.
Lydia Naylor Escape PassAdult Monthly
141 9th St NW Action: Memb rship Cancel Membership Each 1.00 $40.00 ($40.00)
Fee
Carmel,IN 46032 Expires: Dec 1-.:, 2016
Primary phone:(317)232- Pass# 130038 90: Lydia Naylor
1836 Thanks for youi li purchase! This pass will
Email:cwnaylor@hotmail.com automatically renew each month, until cancellation
ID:35883 request is recei'ed. Cancellation request must be
received 7 day prior to billing date.
Total Charges ($80.00)
Total Payments ($80.00)
Balance $0
Federal Tax ID # 35-600097
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