HomeMy WebLinkAbout166547 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: T362227 Page 1 of 1
ONE CIVIC SQUARE THOMASINA AIRGOOD CHECK AMOUNT: $32.00
CARMEL, INDIANA 46032 11006 TOTTENHAM DRIVE
CARMEL IN 46032 CHECK NUMBER: 166547
CHECK DATE: 12/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 204240 32.00 REFUNDS AWARDS INDE
f�
PASS REFUND RECEIPT
Receipt 204240
1 1 DEC Q 2008
Payment Date: 11/24/2008
Household 22421
Home Phone: (317)507 -2448
Work Phone:
THOMASINA AIRGOOD Monon Center
11006 TOTTENHAM DR Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 32.00
Pass Holder: Thomas Kloepfer Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prem. Yrly Ad R (PRMYRADR), #39578 32.00 0.00 32.00 0.00 0.00
Valid Dates: 09/15/2008 to 09/15/2009 Pass Cancellation)
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Prem. Yearly Adult R 32.00 1.00 0.00 0.00 32.00
Cancel Reason: Does not want to contiue membership because he claims he was told the pool was open until
10pm
G/L Code Description Account Number Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 32.00 DR
The REVENUE account was DEBITED and the CONTROL account was CREDITED on the day of the refund.
Finance will have to DEBIT the CONTROL account for the amounts listed above after the checks have been written to the customers.
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 11/24108 09:52:22 by EMB FEES CHANGED ON CANCELLED ITEMS 32.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET`AMOUNT :FROM =CANCELLED'ITEM$... 32:00 -J
TOTAL%AMOUNT REFUNDED_.....=
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 32.00 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. No cash or credit card refunds.
4,,,/ �n lahl
Authorized Sign ure Date Authorized Signature Date
1, 300 'S 40 0 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.
Airgood, Thomasina Terms
11006 Tottenham Drive Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/24/08 204240 Refund 32.00
Total 32.00
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.
Airgood, Thomasina Allowed 20
11006 Tottenham Drive
Carmel, IN 46032
In Sum of
32.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1047 204240 4358400 32.00 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
5 -Dec 2008
Signature
32.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund