HomeMy WebLinkAbout188534 08/03/2010 CITY OF CARMEL, INDIANA VENDOR: 364507 Page 1 of 1
ONE CIVIC SQUARE MATTHEW STEPHENS CHECK AMOUNT: $96.00
CARMEL, INDIANA 46032 2979 BROOKS BEND DRIVE
CARMEL IN 46032 CHECK NUMBER: 188534
CHECK DATE: 813/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 473040 96.00 REFUNDS AWARDS INDE
PASS REFUND RECEIPT
Receipt 473040
Payment Date: 07/14/10
Household 26606
lonon Community Center Matthew Stephens Hm Ph: (317)569 -9544
armel IN 46032 2979 Brooks Bend Drive
Carmel IN 46032 Cell Ph:
nancyestephens @gmail.com
hone: (317)848 -7275
ed Tax ID #35- 6000972
lass Details
CANCELLATION Refund Of 96.00
Pass Holder: Sophia Stephens Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: KZ 50 Visit (M Z50), #76276 54.00 0.00 0.00 54.00 0.00
Valid Oates: 08/10/2009 to 12/31/2099 Pass Cancellation)
Pass Visit into: Number of Visits: 48
Cancel Reason: Upgraded to MCC Household
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 13.75
Processed on 07/14/10 14:08:31 by BNT FEES CHANGED ON CANCELLED ITEMS 150.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 54.00
NET AMOUNT FROM CANCELLED ITEMS 96.00
TOTAL AMOUNT REFUNDED 96.00
NEW NET CREDIT HOUSEHOLD BALANCE 13.75
Refund of 96.00 Made By REFUND FINAN With Reference Upgraded to HH
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. No cash or credit card refunds.
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Aut orized Signature Date Author ed Signature Date
JULY Zulu
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Page 1
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; urkn d of service, where price performed, dates service rendered, by
whom, rates per day, num rat
ber of hours, N
Payee Purchase Order No.
Terms
Stephens, Matthew Date Due
2979 Brooks Bend Drive
Carmel, IN 46032
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s)) 96.00
7114110 473040 Refund
Total 96.00
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with lC 5- 11- 14 -1.6
20
Clerk- Treasurer
Voucher No, Warrant No.
Stephens, Matthew Allowed 20
12979 Brooks Bend Drive
Carmel, IN 46032
In Sum of
96.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1096 -41 473040 4358400 96.00 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
29-Jul 2010
Signature
96.00 Accounts Pale Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund