194954 03/02/2011 CITY OF CARMEL, INDIANA VENDOR: 365137 Page 1 of 1
ONE CIVIC SQUARE WILL AUSTIN
CHECK AMOUNT: $182.00
CARMEL, INDIANA 46032 5272 IVY HILL DRIVE
CARMEL IN 46033 CHECK. NUMBER: 194954
CHECK DATE: 3/2/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 182.00 REFUND
PASS REFUND RECEIPT
Receipt# 578547
Payment Date: 02/17/11
Household 10171
Monon Community Center Will Austin Hm Ph: (317)571 -9992
Carmel IN 46032 5272 Ivy Hill Drive
Carmel IN 46033 Cell Ph:
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 182.00
Pass Holder: Faith Austin Fees Tax DiscounE Prev Paid Our Paid Amount Due
Pass Type: 10 -Visit (ESE10V), #76968 0.00 0.00 0.00 0.00 0.00
Valid Dates: 08/10/2010 to 02/17/2011 Pass Cancellation)
Pass Visit Info: Number of its: 14
Cancel Reason correction (renewal) prorated refund (14 remaining visits) to be issued
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 02117/11 15:21:29 by BJJ FEES CHANGED ON CANCELLED ITEMS 182.00
NETAMOUNTiF ,ROMiCA.NCELL``EDxITEMSJ}
�T.OTAL AMOUNT:REFUNDEDa .9, ,182 §00'x.
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 182.00 Made By REFUND FINAN With Reference
Ali refu ds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issue o cash or credit r un -ds. J
Aut ized Signature Date Authorized Signature Date
Sign up now or volunteer for our Dime Carnival taking place on March 5, from 6 -9pm in the MCC Banquet Rooms. There will
be at least 15 different types of games appropriate for ages 3 -12 years old. The number of tickets required to play varies for
each game. You may play your favorite game as often as you would like; just make sure you don't run out of tickets. Tickets
are 10 cents each, put you may purchase by the dollar. Visit carmelclayparks.com for ticket numbers and pricing.
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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.
Austin, Will Terms
5272 Ivy Hill Drive Date Due
Carmel, IN 45033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/17111 578547 Refund 182.00
Total 182.00
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.
Austin, Will Allowed 20
5272 Ivy Hill Drive
Carmel, IN 46033
In Sum of$
182.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -7 578547 4358400 182.00 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
24 -Feb 2011
Signature
182.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund