161846 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 361618 Page 1 of 1
ONE CIVIC SQUARE WENDY HAINES
CARMEL, INDIANA 46032 4855 N KESSLER BLVD CHECK AMOUNT: $160.16
INDIANAPOLIS IN 46228 CHECK NUMBER: 161846
CHECK DATE: 7/23/2008
DEPARTMENT ACCOUNT P N UMBER INVOICE NUMBE AMO DESCRIPTION
1047 4358400 160.16 PARKS DEPARTMENT REFU
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PASS REFUND RECEIPT
Receipt 149301
Payment Date: 07/11/2008
Household 8533 JUL 1 5 2008
Home Phone: (317)299 -3335
Work Phone: [BY
WENDY HAINES Carmel Clay Parks Recreation
4855 N. KESSLER BLVD. 1235 Central Park Drive East
INDIANAPOLIS IN 46228 Carmel IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 160.16
Pass Holder: Wendy Haines Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Seas AQ HH Non (SAQHN), #7596 147.84 0.00 147.84 0.00 0.00
Valid Dates: 05/24/2008 to 09/01/2008 Pass Cancellation)
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Seas Aqua HH NR 147.84 1.00 0.00 0.00 147.84
Cancel Reason: Child no longer meets height requirement
CANCELLATION
Pass Holder: David Haines Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Ses AQ HH NonAD (SAQHNADD), #7597 0.00 0.00 0.00 0.00 0.00
Valid Dates: 05/24/2008 to 09/01/2008 Pass Cancellation)
Cancel Reason: Child no longer meets height requirement
CANCELLATION
Pass Holder: Joseph Haines Fees Tax Discount Prev Paid Our Paid Amount Due
Pass Type: Ses AQ HH NonAD (SAQHNADD), #7598 0.00 0.00 0.00 0.00 0.00
Valid Dates: 05/24/2008 to 09/01/2008 Pass Cancellation)
Cancel Reason: Child no longer meets height requirement
CANCELLATION
Pass Holder: Daniel Haines Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Ses AQ HH NonAD (SAQHNADD), #7599 0.00 0.00 0.00 0.00 0.00
Valid Dates: 05/24/2008 to 09/01/2008 Pass Cancellation)
Cancel Reason: Child no longer meets height requirement
Page 1
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PASS REFUND RECEIPT
Receipt 149301
Payment Date: 07/11/08
Household 8533
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 160.16 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 07/11108 14:42:19 by LVA FEES CHANGED ON CANCELLED ITEMS 160.16
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NETAMOUNT!FROM CANCELLED ITEMS
TOTAL AMOUNT_ REFUNDED.: 160.16
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 160.16 Made By REFUND FINAN With Reference
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
iss s o redit card refunds.
`thorized Signature Date Authorized Signature Date
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Page #2
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.
Haines, Wndy Terms
4855 N Keesler Blvd. Date Due
Indianapolis, IN 46228
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7111108 149301 Refund 160.16
Total 160.16
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.
Haines, Wndy Allowed 20
4855 N Keesler Blvd.
Indianapolis, IN 46228
In Sum of
160.16
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or Board Members
Dept INVOICE NO. ACCT #/TITLE AMOUNT
1047 149301 4358400 160.16 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
18 -Jul 2008
Signature
160.16 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund