163974 09/17/2008 CITY OF CARMEL, INDIANA VENDOR: T361813 Page 1 of 1
a ONE CIVIC SQUARE TANYA ARCHER
CARMEL, INDIANA 46032 147 PINEVIEW DR. APT 1 CHECK AMOUNT: $51.00
CARMEL IN 46032
CHECK NUMBER: 163974
CHECK DATE: 9/17/2008
DEPA ACCOUNT PO NUMBER INVO NUMBER AMOUNT DESCRIPTION
1046 4358400 178879 41.00 REFUNDS AWARDS INDE
1046 4358400 181612 10.00 REFUNDS AWARDS INDE
r
PASS REFUND RECEIPT
Receipt 178879 Payment Date: 08/19/2008 I
Household 12620 ,d
Home Phone: (317)519 -1923 SB��
Work Phone: (317) 1
vo N9
TANYA ARCHER Carmel Elementary
147 PINEVIEW DRIVE APT. 1 '.(,F.1VFi_,1D 101 4th Avenue SE
CARMEL IN 46032 Carmel IN 46033
S E P 0 2 2008 Phone: (317)848 -7275
Fed Tax ID #35- 6000972
BY:
Pass Details
Pass Holder: Emily Archer Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Aug Month PM (ESEMAP), #35926 10.00 0.00 0.00 10.00 0.00
Valid Dates: 08/12/2008 to 08/29/2008 Pass Transfer from 4 -5 Week 1 PM)
Fee Details: Fee D Amount Count Discount Sales Tax Total Fee
Aug Monthly PM 0.00 1.00 0.00 0.00 0.00
ESE Late Payment Fee 5.00 1.00 0.00 0.00 5.00
ESE Late Payment Fee 5.00 1.00 0.00 0.00 5.00
_G /L Code_ Descriptio Account Number Cst Cntr Description_____,_________ Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 41.00 DR
The REVENUE account was DEBITED and the CONTROL account was CREDITED on the day of the refund.
Finance will have to DEBIT the CONTROL account for the amounts listed above after the checks have been written to the customers.
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 08/19/08 17:43:42 by SLH FEES ADJUSTED ON CHANGED ITEMS 41.00
DISCOUNT APPLIED AGAINST THESE FEES 0.00
NET FROM/TO TRANSFER TAX 0.00
NET AMOUNT FROM CHANGED ITEMS
TOTAL AMOUNT AMOUNT REFUNDED 41.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 41.00 Made By REFUND FINAN With Reference
Payment of 10.00 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. cash =�ds.
uthori Signature r n Date Authorized Signature Date
Page 1
PASS REFUND RECEIPT
Receipt 181612 t
Payment Date: 08/28/2008 I
Household 12620 U
Home Phone: (317)519 -1923
Work Phone: (317)
TANYA ARCHER Monon Center
147 PINEVIEW DRIVE APT. 1 Carmel IN 46032
CARMEL IN 46032
S E P 0 2 2008 Phone: (317)848 -7275
Fed Tax ID #35- 6000972
BY:
Pass Details
MEMBERSHIP CHANGE Refund Of 10.00
Pass Holder: Emily Archer Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Aug Month PM (ESEMAP), #35926 0.00 0.00 0.00 0.00 0.00
Valid Dates: 08/12/2008 to 08/29/2008 Pass Change)
Fee Details: Fee Des cription _____._Count Di sc_o_unt Sales Tax Tota F ee_
Aug Monthly PM 0.00 1.00 0.00 0.00 0.00
G/L Code Description Account Number Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 10.00 DR
The REVENUE account was DEBITED and the CONTROL account was CREDITED on the day of the refund.
Finance will have to DEBIT the CONTROL account for the amounts listed above after the checks have been written to the customers.
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 08/28/08 13:18:20 by BJJ FEES ADJUSTED ON CHANGED ITEMS 10.00
DISCOUNT APPLIED AGAINST THESE FEES 0.00
SALES TAX CHARGED ON CHANGED FEES 0.00
NET AMOUNT, FROM CHANGED ITEMS 10.00-
TOTAL AMOUNT REFUNDED 10.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 10.00 Made By REFUND FINAN With Reference
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. cash or credit card refunds.
A ed Signature Date Authorized Signature Date
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.
Archer, Tanya Terms
147 Pineview Drive Apt. 1 Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/19/08 178879 Refund 41.00
8/28/08 181612 Refund 10.00
Total 51.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Archer, Tanya Allowed 20
147 Pineview Drive Apt. 1
Carmel, IN 46032
I n Sum of
51.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#[TITLE AMOUNT Board Members
Dept
1046 178879 4358400 41.00 hereby certify that the attached invoice(s), or
1046 181612 4358400 10.00 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
i
2 -Sep 2008
Signature
51.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
4:e