HomeMy WebLinkAbout182073 02/03/2010 a CITY OF CARMEL, INDIANA VENDOR: 363856 Page 1 of 1
74 ONE CIVIC SQUARE CHRISTINA ROSE
CARMEL, INDIANA 46032 6528AMHERST WAY CHECK AMOUNT: $55.50
-,'4, ZIONSVILLE IN 46077 CHECK NUMBER: 182073
CHECK DATE: 2/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 55.50 REFUND
IV
PASS REFUND RECEIPT
Receipt 378161
Payment Date: 01/17/10
Household 20571
Monon Center Christina Rose Hm Ph: (317)769 -4281
Carmel IN 46032 6528 Amherst Way
Zionsville IN 46077 Cell Ph:
christinateeter @yahoo.com
Bone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 55.50
Pass Holder: Christina Rose Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: KZ 50 Visit (M Z50), #82517 19.50 0.00 19.50 0.00 0.00
Valid Dates: 09/24/2009 to 12/31/2099 Pass Cancellation)
Pass Visit Info: Number of Visits: 37
Cancel Reason: new rates /KZ included
G/L Code Description Account Number Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 55.50 DR
The REVENUE account was DEBITED and the CONTROL account was CREDITED on the day of the refund.
Finance will have to DEBIT the CONTROL account for the amounts listed above after the checks have been written to the customers.
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 01/17/10 13:50.19 by RDG FEES CHANGED ON CANCELLED ITEMS 55.50
NET AMOUNT.>FROM.CANCELLED IT,EMSD 55.50d
I' :TOTAL AMOUNT;REFUNDEDF:::"'";"'.' r 55;50'.
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 55.50 Made By REFUND FINAN With Reference
All refundsfixe- subject to State Bo' d --of Acca is claim procedure and may take 4 -6 weeks to process. A check will be
issued o cash or credit card ref nds.
n" t 1 i 4 1
\i t Signature Date Authorized Signature Date
4 7 (CO e eD
Page 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.
Rose, Christina Terms
6528 Amherst Way Date Due
Zionsville, IN 46077
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/17/10 378161 Refund 55.50
Total 55.50
I 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.
Rose, Christina Allowed 20
6528 Amherst Way
Zionsville, IN 46077
In Sum of$
55.50
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or Board Members
INVOICE NO. ACCT #/TITLE AMOUNT
Dept
1092 378161 4358400 55.50 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
28 -Jan 2010
Signature
55.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund