183636 03/25/2010 CITY OF CARMEL, INDIANA VENDOR: 363995 Page 1 of 1
ONE CIVIC SQUARE JOE GILBERT
CHECK AMOUNT: $70.50
CARMEL, INDIANA 46032 1399 PRAIRIE CREEK COURT
CARMEL IN 46032 CHECK NUMBER: 183636
CHECK DATE: 3/25/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 70.50 REFUNDS AWARDS INDE
PASS REFUND RECEIPT
Receipt 401754
Payment Date: 03/19/10
Household 14846
4 .G
4 Y}
Monon Center rte. Joe Gilbert Him Ph: (317)587 -8898
Carmel IN 46032 1399 Prairie Creek Ct Wk Ph: (317)324 -9709
Carmel IN 46032 Cell Ph:
paige.gilbert @yahoo.com
Phone: (317)848 -7275
Fed Tax ID 435- 6000972
Pass Details
CANCELLATION Refund Of 70.50
Pass Holder: Paige Gilbert Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: KZ 50 Visit (M Z50), #19003 4.50 0.00 4.50 0.00 0.00
Valid Dates. 11/24/2009 to 12/31/2099 Pass Cancellation)
Pass Visit Info: Number of Visits: 47
Cancel Reason: prorated request
G /L.Code Description Account-Number Cst Cnt_r___ Description Account Nu _Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 70.50 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 CREDIT HOUSEHOLD BALANCE 22.50
Processed on 03/19/10 12:32:19 by LVA FEES CHANGED ON CANCELLED ITEMS 70.50
NET AMOUNT FROM CANCELLED ITEMS 70.50
TOTAL AMOUNT REFUNDED, 70.50
NEW NET CREDIT HOUSEHOLD BALANCE 22.50
Refund of 70.50 Made By REFUND FINAN With Reference prorated request
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issue o cash or cr �t cad refunds.
Authorized S11 ure Da e Authorizei Signature Date
Page 4 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,
Gilbert, Joe Terms
1399 Prairie Creek Ct. Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3!19!10 401754 Refund 70.50
Total 70.50
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.
Gilbert, Joe Allowed 20
1399 Prairie Creek Ct.
Carmel, IN 46032
In Sum of$
70.50
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -41 401754 4358400 70.50 1 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
25 -Mar 2010
Signature
70.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund