164146 09/30/2008 C� CITY OF CARMEL, INDIANA VENDOR: T361893 Page 1 of 1
z ONE CIVIC SQUARE RUTH BELIN
CARMEL, INDIANA 46032 10534 COPPERGATE DR
CHECK AMOUNT: $165.00
y 'i;'.O:• CARMEL iN 46032
CHECK NUMBER: 164146
CHECK DATE: 913012008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER A DESCRIPTIO
1047 4358400 165.00 REFUNDS AWARDS INDE
a A
E.
i
ACTIVITY REFUND RECEIPT
Receipt 189789 DECEIVED
Payment Date: 09/23/2008 SEP 2 5 2008
Household 18327
Home Phone: (410)262 -7283
Work Phone: (703)244 -1540 BY
RUTH BELIN Monon Center
10534 COPPERGATE DRIVE Carmel IN 46032
CARMEL IN 46032
'1
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 165.00- 165.00 0.00
G/L Code Descri Account Number Cst C ntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 165.00 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 165.00
Processed on 09/23/08 08:40:05 by TCP NEW REFUND AMOUNT 165.00
TOTAL REFUNDABLE AMOUNT 165.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 165.00 Made By REFUND FINAN With Reference hh credit to check
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.
T�Rn(- q
Authorized 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.
Belin, Ruth Terms
10534 Coppergate Dr Date Due
r
Carmel, IN 46032
1
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/23/08 189789 Refund 165.00
Total 165.00
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.
Belin, Ruth Allowed 20
10534 Coppergate Dr
Carmel, IN 46032
In Sum of
165.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 189789 4358400 165.00 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
25 -Sep 2008
Signature
165.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund