HomeMy WebLinkAbout182375 02/17/2010 CITY OF CARMEL, INDIANA VENDOR: 363891 Page 1 of 1
ONE CIVIC SQUARE ANDY HARTSOCK CHECK AMOUNT: $40.50
CARMEL, INDIANA 46032 13121 BRIARWOOD TRACE
CARMEL IN 46033 CHECK NUMBER: 182375
CHECK DATE: 2/1712010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 383765 40.50 REFUNDS AWARDS INDE
PASS REFUND RECEIPT
Receipt 383765
Payment Date: 02/02110
Household 1696
Monon Center Andy Hartsock Hm Ph: (317)574 -1735
Carmel IN 46032 13121 Briarwood Trace
Carmel IN 46033 Cell Ph:
ahartsock @iquest.net
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 40.50
Pass Holder: Amy Hartsock Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: KZ 50 Visit (M Z50), #81312 34.50 0.00 34.50 0.00 0.00
Valid Dates: 09/0912009 to 12/31/2099 Pass Cancellation)
Pass Visa Info: Number of Visits: 27
Cancel Reason: advanced request
G/L Cod e_ Description_ Accoun Num ber Cntr___ Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 40.50 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 02102/10 16:13:24 by LVA FEES CHANGED ON CANCELLED ITEMS 40.50
NET AMOUNT FROM CANCELLED ITEMS 40.50
TOTAL AMOUNT REFUNDED 40.50
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 40.50 Made By REFUND FINAN With Reference advanced request
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. No cash or credit card refunds.
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ACCOUNTS PAYABLE VOUCHER
M 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.
Hartsock, Andy Terms
13121 Briarwood Trace Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoices) or bill(s)) Amount
40.50
2!2110 383765 Refund
Total 40.50
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
1 20
Clerk Treasurer
Voucher No. Warrant No.
Hartsock, Andy Allowed 20
13121 Briarwood Trace
Carmel, IN 46033
In Sum of
40.50
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept
1096 -41 383765 4358400 40.50 l 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
11 -Feb 2010
Signature
40.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund