HomeMy WebLinkAbout194683 02/16/2011 CITY OF CARMEL, INDIANA VENDOR: 365078 Page 1 of 1
0 ONE CIVIC SQUARE REBECCA MALENKOS CHECK AMOUNT: $12.00
qa CARMEL, INDIANA 46032 1224 E 126TH ST
CARMEL IN 46033 CHECK NUMBER: 194683
CHECK DATE: 2/16/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 12.00 PARKS DEPARTMENT REFU
PASS REFUND RECEIPT
Receipt 569896
Payment Date: 02/03/11
Household 34499
Carmel Clay Parks Recreation Rebecca Malenkos Hm Ph: (317)846 -1452
1235 Central Park Drive East 1224 E. 126th St. Wk Ph: (317)846 -7721
Carmel IN 46032 Carmel IN 46033 Ext. 7122
irontin @sbcglobal.net Cell Ph: (317)
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 12.00
Pass Holder: Rebecca Malenkos Fees +Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Corp UnIGrpFit (CORP UGF), #111043 100.00 0.00 0.00 100.00 0.00
Valid Dates: 06/29/2010 to 04/21/2011 Pass Cancellation)
The following item reflects a payment towards a previous receipt
Pass Holder: Rebecca Malenkos Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Corp 20 Adult (CORP 20A), #104489 196.00 0.00 168.00 28.00 0.00
Valid Dates: 04/21/2010 to 04/21/2011 Pass Cancellation)
PREVIOUS NET HOUSEHOLD BALANCE 28.00
Processed on 02/03/11 10:28:59 by ABK FEES CHANGED ON CANCELLED ITEMS 140.00
SURCHARGE APPLIED AGAINST CANCELLED FEES O 100.00
NET;'AMOUNTKFROM CANCELLED3ITiEMS`
FEES ADJUSTED ON CHANGED ITEMS 0.00
NET:AIVIOIfNT�F„ROM:CHANGED ITEMS:
HH BALANCE APPLIED TO THIS RECEIPT 28.00
TOTAL-AMOUNT;REFUNDED
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 12.00 Made By REFUND FINAN With Reference
Payment of 28.00 Made By Pass Management Credit Balance
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 redit card refunds. L� D
Jz) 9, 0 1 -13 5
�,d I,V Z 2n S
Authorized 9ignatz. Date Authorized Signature Date
Mothers, bring your little prince to Prince Charming's Ball and share a Valentine's evening of enchantment and wonder at this
ballroom -style event. The event will be held on Friday, February 4 from 6 -9pm at the MCC. Fee is $15 /person. Register at
www.cartnelclayparks.com. Pre registration is required (activity# 319047 -01).
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,
Malenkos, Rebecca Terms
1224 E. 126th St Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
213111 569896 Refund 12.00
Total 12.00
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.
Malenkos, Rebecca Allowed 20
1224 E. 126th St
Carmel, IN 46033
In Sum of
12.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #(TITLE AMOUNT Board Members
Dept
1096 -22 569896 4358400 12.00 I 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
10 -Feb 2011
Signature
12.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund