156153 02/06/2008 CITY OF CARMEL, INDIANA VENDOR: T360814 Page 1 of 1
ONE CIVIC SQUARE MARC ELFENBAUM CHECK AMOUNT: $127.72
CARMEL, INDIANA 46032 13299 LORENZO BLVD
WESTFIELD IN 46074 CHECK NUMBER: 156153
CHECK DATE: 216/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 87310 127.72 REFUNDS AWARDS INDE
PASS REFUND RECEIPT
Receipt 87310 R CEIVF D
Payment Date: 01/23/2008
Household 7063 �A 3 0
H6ne Phone: (317)733 -8899 2008
Work Phone: (317)249 -2741
BY: ct a o
MARC ELFENBAUM Monon Center
13299 LORENZO BLVD. Carmel IN 46032
WESTFIELD, IN 46074
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 127.72
Pass Holder: Sharon Elfenbaum Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prem. Yrly Ad R (PRMYRADR), #3213 252.28 0.00 252.28 0.00 0.00
Valid Dates: 05/25/2007 to 05/25/2008 Pass Cancellation)
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Prem. Yearly Adult R 252.28 1.00 0.00 0.00 25228
G/L Code Description Account N Cntr Description Ac count N umber Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 127.72 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 30.00
Processed on 01/23/08 16:56:39 by EDR FEES CHANGED ON CANCELLED ITEMS 127.72
DISCOUNT APPLIED AGAINST CANCELLED FEES O 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET:AMOUNTFROMCANCELLED.ITEMS 127.72
TOTAL'AMOUNT REFUNDED; 127:72
NEW NET HOUSEHOLD BALANCE 30.00
Refund Type: Refund from Finance
Refund of 127.72 Made By JOURNAL -RF With Reference
This refund will be mailed to Marc Elfunbaum
13299 Lorenzo Blvd
Westfield, IN 46074
Page 1
PASS REFUND RECEIPT
Receipt 87310
9 Payment Date: 01/23/08
Household 7063
r
All refunds re su t f ate Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
isstte4. -fro cash t card refu s.
L Z 3 f 1 Z 9�vg
Authoriz Signature Date Authorized Signature Date
3
Page 2
ACCOUNTS PAYABLE,- VOUCHER
CITY OF CARMEL
5
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.
I
Payee
Purchase Order No.
Marc Elfenbaum Terms
13299 Lorenzo Blvd. Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/23/08 87310 Refund 127.72
Total 127.72
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.
Marc Elfenbaum Allowed 20
13299 Lorenzo Blvd,
Westfield, IN 46074
In Sum of
127.72
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 87310 4358400 127.72 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
30 -Jan 2008
Si na e
127.72 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund