187765 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 364414 Page 1 of 1
ONE CIVIC SQUARE SALLY DALLAS
9
CARMEL, INDIANA 46032
5539 SALEM DR S CHECK AMOUNT: $36.00
ti ro„ L� CARMEL IN 46033 CHECK NUMBER: 187765
CHECK DATE: 7!2112010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 466965 36.00 REFUNDS AWARDS INDE
GLOBAL REFUND RECEIPT
Receipt# 466965
Payment Date: 07/07/10
Household 31705
Monon Community Center Sally Dallas Hm Ph: (317)575 -0411
Carmel IN 46032 5539 Salem Dr. S.
Carmel IN 46033 Cell Ph:
Phone: (317)848 -7275 nickdallasl7@yahoo.com
Fed Tax ID #35- 6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 36.00- 36.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 36.00
Processed on 07/07110 21:16:07 by TLP NEW REFUND AMOUNT I 36.00
TOTAL REFUNDABLE AMOUNT 36.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 36.00 Made By REFUND FINAN With Reference staff error; sold VP- shldBmfit
Ali refunds are subject to Staq Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. N or c7 refunds.
Authorized Signat a Date Authorized Signature Date
V t err'
J t or
b 9 ca Q 1i 1 4 2010 i
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.
Dallas, Sally Terms
5539 Salem Dr. S. Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
717110 466965 Refund 36.00
Total 36.00
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.
Dallas, Sally Allowed 20
5539 Salem Dr. S.
Carmel, IN 46033
In Sum of
36.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO #or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1092 466965 4358400 36.00 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
15 -Jul 2010
Signature
36.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund