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Home My WebLink About155269 01/10/2008 CITY OF CARMEL, INDIANA VENDOR: 360696 Page 1 of 1 ONE CIVIC SQUARE JANE DICKERSON 0 CHECK AMOUNT: $171.00 CARMEL, INDIANA 46032 856 PRESTON DR INDPLS IN 46280 CHECK NUMBER: 155269 CHECK DATE: 1/1012008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1047 4358400 76910 171.00 REFUNDS AWARDS INDE '1 PASS REFUND RECEIPT eczipt 76910 I ayment Date: 12/17/2007 ousehold 5667 DEC 1 9 2007 ome Phone: (317)846 -7919 /ork Phone: (317) gr_ JANE DICKERSON Monon Center 856 PRESTON DRIVE Carmel IN 46032 INDIANAPOLIS, IN 46280 Phone:. (317)848 -7275 Fed Tax ID #35- 6000972 'ass Details CANCELLATION Refund Of 171.00 Pass Holder: Jane Dickerson Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Prem. Yrly Ad R (PRMYRADR), #1437 209.00 0.00 209.00 0.00 0.00 Valid Dates: 04/15/2007 to 05/31/2008 Pass Cancellation) Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee Prem. Yearly Adult R 209.00 1.00 0.00 0.00 209.00 Cancel Reason: part-time employee, eligible for pass at no charge 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 171.00 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 12/17/07 13:56:11 by CEK FEES CHANGED ON CANCELLED ITEMS 171.00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 NET ,AMOUNT FROWCANCELLED "ITEMS 171.00 TOTAL,AMOUNT. REFUNDED 171 00 NEW NET HOUSEHOLD BALANCE 0.00 Refund Type: Refund from Finance Refund of 171.00 Made By JOURNAL -RF With Reference cancel, employee 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. ww C (-1-/17/q 1 U� Authorized Signature Date Auth d igna ure Date o r Page 1 r ACCOUNTS PAYABL'EVOUCHER 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. Jane Dickerson Terms 856 Preston Drive Date Due Indianapolis, IN 46280 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/17/07 76910 Refund 171.00 Total 171.00 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. Jane Dickerson Allowed 20 856 Preston Drive Indianapolis, IN 46280 In Sum of 171.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 76910 4358400 171.00 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 Signa re 171.00 Busines ervic rManager Cost distribution ledger classification if Title claim paid motor vehicle highway fund