158308 04/15/2008 CITY OF CARMEL, INDIANA VENDOR: T361163 Page 1 of 1
ONE CIVIC SQUARE CARMEN BUSHUE
CARMEL, INDIANA 46032 14484 SADDLEBACK DR CHECK AMOUNT: $21.00
CARMEL IN 46032 CHECK NUMBER: 158308
no„
CHECK DATE: 4/15/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION
1047 4358400 102386 21.00 REFUNDS AWARDS INDE
I
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ACTIVITY REFUND RECEIPT
Receipt 102386 RECIEIVED
Payment Date: 03/25/2008
Household 10517 MAR 3 1 2008
Home Phone: (317)566 -0452
Work Phone: !`f LAY-
CARMEN BUSHUE Carmel Clay Parks Recreation
14484 SADDLEBACK DR 1235 Central Park Drive East.
CARMEL, IN 46032 Carmel IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Oria Bai Refund New Bad
Module: Activity Registration 21.00- 21.00 0.00
PREVIOUS NET HOUSEHOLD BALANCE 21.00
Processed on 03/25/08 11.55.13 by SAC NEW REFUND AMOUNT 21.00
TOTAL REFUNDABLE AMOUNT 21.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund Type: Refund from Finance
Refund of 21.00 Made By JOURNAL -RF With Reference wanted check
All refunds are subject to State Board of Accounts claim procedure and may take 4- &..weeks to process. A check will be
ued. No cash or credit card refunds.
Authorized Signature Dale utho zed Signature ate
370.300.q
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.
Carmen Bushue Terms
14484 Saddleback Drive Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s))
Amount
21.00
3/25/08 102386 Refund
Total 21.00
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with 1C 5- 11- 10 -1.6
20
Clerk- Treasurer
Voucher No. Warrant No.
Carmen Bushue Allowed 20
14484 Saddleback Drive
Carmel, IN 46032
In Sum of
21.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program 'Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 102386 4358400 21.00 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
31 -Mar 2008
6, <e4�
Si atur
21.00 Business ices Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund