165137 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: T362035 Page 1 of 1
e tiFl ONE CIVIC SQUARE CHRIS BELCHER
O i 12422 PASTURE VIEW CT CHECK AMOUNT: $17.00
CARMEL, INDIANA 46032
CARMEL IN 46033 CHECK NUMBER: 165137
CHECK DATE: 10/2912008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
,1047 4358400 192189 17.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Reeeipt# 192189 T�FC~FIVED
Payment Date: 10/06/2008
Household 876 OCT 1 4 2008
Horne Phone: (317)580 -9532
Work Phone:
CHRIS BELCHER Monon Center
12422 PASTURE VIEW CT. Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Orio Bal Refund New Bal
Module: Activity Registration 17.00- 17.00 0.00
G/L Code_ Description________.______ Account_Number Cs_t_Cntr.____ Description Account Numb_er____ ____Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 17.00 DR
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 17.00
Processed on 10/06/08 10:04:09 by MML NEW REFUND AMOUNT 17.00
TOTAL REFUNDABLE AMOUNT 17.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 17.00 Made By REFUND FINAN With Reference overcharged
All refunds ao subject to State Board of ccounts claim procedure and may take 4 -6 weeks to process. A check will be
issued s r edit c refund
thor ed Signat re Date Authorized Signature Date
ror.
l� l
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.
Belcher, Chris Terms
12422 Pasture View Ct Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/6/08 192189 Refund 17.00
Total 17.00
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.
Belcher, Chris Allowed 20
12422 Pasture View Ct
Carmel, IN 46033
In Sum of
17.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept
1047. 192189 4358400 17.00 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
15 -Oct 2008
Signature
17.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund