187790 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 364419 Page 1 of 1
0 ONE CIVIC SQUARE MEGAN EWING CHECK AMOUNT: $100.00
CARMEL, INDIANA 46032 5639 W 900 N
MCCORDSVILLEIN 46055 CHECK NUMBER: 187790
CHECK DATE: 7/21/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1092 4358400 467741 100.00 REFUNDS AWARDS INDE
PASS REFUND RECEIPT
Receipt 467741
Payment Date: 07/09/10
Household M. 31783
Mcrnon Community Center Megan Ewing Hm Ph: (317)318 -5850
Carmel IN 46032 5639 W 900 N
McCordsville IN 46055 Cell Ph:
ewing.megane @gmail.com
Phone: (317)848 -7275
Fed Tax 0 #35- 6000972
Pass Details
CANCELLATION Refund Of 100.00
Pass Holder: Megan Ewing Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: FIT Adit Mnthly (XM FTAM), #92769 120.00 0.00 0.00 120.00 0.00
Valid Dates 1 2/31/2009 to 11/30/2010 Pass Can
Cancel Re on: cancelled pass 6/9/10, annual pass paid in full 12/31/09. refund needed.
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07109/10 09:52:55 by TLP FEES CHANGED ON CANCELLED ITEMS 220.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 120.00
NET AMOUNT FROM CANCELLED ITEMS 100.00
TOTAL AMOUNT REFUNDED 100.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 100.00 Made By REFUND FINAN With Reference annl cancellation
All refunds are subject t er! ounts claim procedure and may take 4 6 weeks to process. A check will be
issued. No cash or c Au r lhoriz d Si nature Date Authorized Signature Date
F 6
l 1 4 2010
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.
Ewing, Megan Terms
5639 W 900 N Date Due
McCordsville, IN 46055
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
719110. 467741 Refund 100.00
Total 100.00
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.
Ewing, Megan Allowed 20
5639 W 900 N
McCordsville, IN 46055
In Sum of
100.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1092 467741 4358400 100.00 1 hereby certify that the attached invoice(s), or
bills) 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
100.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund