HomeMy WebLinkAbout155194 01/10/2008 CITY OF CARMEL, INDIANA VENDOR: 360692 Page 1 of 1
0 ONE CIVIC SQUARE HILARY BALLARD
CARMEL, INDIANA 46032 639 WOODCLIFF DR CHECK AMOUNT: $48.00
SOUTH BEND IN 46615
CHECK NUMBER: 155194
CHECK DATE: 1/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 78391 48.00 REFUNDS AWARDS INDE
`l
PASS REFUND RECEIPT
Receipt 78391
Payment Date: 12/19/2007 7DEEC Ho usehold 12351 Home Phone: (574)514 -6285
Work Phone: 2
HILLARY BALLARD Monon Center
9439 ED aA/6� Pb ✓0-> Carmel IN 46032
APOLIS, IN 46240
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 48.00
Pass Holder: Hillary Ballard Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prem. Yrly Ad N (PRMYRADN), #14441 144.00 0.00 144.00 0.00 0.00
Valid Dates: 09/11/2007 to 09/11/2008 Pass Cancellation)
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Prem. Yearly Adult N 144.00 1.00 0.00 0.00 144.00
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 48.00 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 12119/07 13:21:44 by EDR FEES CHANGED ON CANCELLED ITEMS 48.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM +CANCEL'LED. ITEMS,
48.00r''
TOTAL AMOUNT`REFUNDED 48.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund Type: Refund from Finance
Refund of 48.00 Made By JOURNAL -RF With Reference
All ref -er subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
iss No ca or cred't card refunds.
th d' II Jtt ur Da a thoriz d 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,
Hillary Ballard Terms
639 Woodcliff Dr. Date Due
South Bend, IN 46615
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/19107 78391 Refund 48.00
Total 48.00
i 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.
Hillary Ballard Allowed 20
639 Woodcliff Dr.
South Bend, IN 46615
In Sum of
48.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1047 78391 4358400 48.00 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
4 -Jan 2008
EE Sign ure
ff$48.00 Busin Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund