184980 04/27/2010 CITY OF CARMEL, INDIANA VENDOR: 364103 Page 1 of 1
ONE CIVIC SQUARE SARAH WALDEN
CARMEL, INDIANA 46032 9350 BENCHMARK DR., APT C CHECK AMOUNT: $80.00
INDIANAPOLIS IN 46240
CHECK NUMBER: 184980
CHECK DATE: 4/27/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 414174 80.00 REFUNDS AWARDS INDE
PASS REFUND RECEIPT
Receipt 414174
E Payment Date: 04/22/10
i f Household 15774
APR 2; 2010
Monon Center Sarah Walden Hm Ph: (217)257 -1488
Carmel IN 46032 BY:......... 9350 Benchmark Dr
Apt C Cell Ph:
Indianapolis IN 46240
Phone: (317)848 -7275 swalden24 @gmail.com
Fed Tax ID #35- 6000972
Pass Details
MEMBERSHIP CHANGE Refund Of 80.00
Pass Holder: Sarah Walden Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type FIT Adlt Mnthly (M FTAM), #20451 4.00 0.00 4.00 0.00 0.00
Valid Dates: 01/22/2010 to 02/0212011 Pass Change)
G/L Code_ Descri Account Number Cst Cntr Descri Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 80.00 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 04/22/10 13:04:55 by TLP FEES ADJUSTED ON CHANGED ITEMS 80.00
NET AMOUNT FROM CHANGED ITEMS 80.00
TOTAL AMOUNT REFUNDED 80.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 80.00 Made By REFUND FINAN With Refere ce non res rate refund
All refunds are subject to Board of c unts claim procedure and may take 4 -6 weeks to process. A check will be
issued. or credi car refunds
Authorized Signature Date Authorized Signature Date
O
1
Page 1
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice ofIbill 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.
Walden, Sarah Terms
9350 Benchmark Dr, Apt. C Date Due
Indianapolis, IN 46240
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4122110 414174 Refund 80.00
Total 80.00
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20_
Clerk- Treasurer
Voucher No. Warrant No.
i t
Walden, Sarah Allowed 20
9350 Benchmark Dr, Apt. C
Indianapolis, IN 46240
In Sum of$
80.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1092 414174 4358400 80.00 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
26 -Apr 2010
3 f
Signature
80.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund