186198 06/09/2010 CITY OF CARMEL, INDIANA VENDOR: 364226 Page 1 of 1
ONE CIVIC SQUARE BETH BATES
s, a CARMEL, INDIANA 46032 555 HAWTHORNE DRIVE CHECK AMOUNT: $24.00
CARMEL IN 46033 CHECK NUMBER: 186198
CHECK DATE: 6/9/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 24.00 REFUND
7 7
3
PASS REFUND RECEIPT p
z
Receipt# 426183
Payment Date: 05/25/10
Household 11820
tt� 1
9 MAY 5 1010
Monon CenterBeth Bates Hm Ph: (317)575 -9927
Carmel IN 46032 555 Hawthorne Drive
C
BY" armel IN 46033 Cell Ph:
Ffone: (317)848 -7275 bates @ccs.k12.in.us
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 24.00
Pass Holder: Grace Coleman Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: 10 -Visit (ESE10V), #42888 16.00 0.00 16.00 0.00 0.00
Vaud Dates: 08/11/2009 to 05/27/2010 Pass Cancellation)
Pass Visit Info: Number of Visits: 6
Cancel Reason: prorated punchcard refund
GIL 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 24.00 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 05/25/10 08:48:23 by JAB FEES CHANGED ON CANCELLED ITEMS 24.00
NET AMOUNT FROM CANCELLED ITEMS 24.00
TOTAL AMOUNT REFUNDED 24.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 24.00 Made By REFUND FINAN With Reference check refund
All refunds a subjec o State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
ssu No ash or cr dit card refunds.
U �0
Autho ze Si nature Date Authorized Signature Date
Ik �A Uj�/LQ
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.
Bates, Beth Terms
555 Hawthorne Drive Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number
or note attached invoice( s) or bill Amount
5125110 426183 Refund 24.00
Total 24.00
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
PPPl
Voucher No. Warrant No.
Bates, Beth Allowed 20
555 Hawthorne Drive
Carmel, IN 46033
In Sum of
24.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or Board Members
Dept ept INVOICE NO. ACCT #ITITLE AMOUNT
1081 -5 426183 4358400 24.00 1 hereby certify that the attached invoice(s), or
hill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
3 -Jun 2010
Signature
24.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund