157051 03/05/2008 CITY OF CARMEL, INDIANA VENDOR: T360815 Page 1 of 1
4 ONE CIVIC SQUARE CRUZ ESCdTd CHECK AMOUNT: $280.00
CARMEL, INDIANA 46032 14135 NICHOLAS DR
WESTFIELDIN 46074 CHECK NUMBER: 157051
CHECK DATE: 31512008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 .280.00 PARKS DEPARTMENT REFU
c-
I
i
PASS REFUND RECEIPT
Receipt 83343
Payment Date: 01/10/2008 FFEEB D
Household 12808
Home Phone: (317)566 -0773 2008
Word Phone: (317)406 -2647
CRUZ ESCOTO Monon Center
14135 NICHOLAS DR Carmel IN 46032
WESTFIELD, IN 46074
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
Pass Holder: Cruz Escoto Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly FT Alt Res (YFTAR), #19031 240.00 0.00 240.00 0.00 0.00
valid Dates: 01/10/2008 to 01/10/2009 Pass Transfer from Prem. Yrly Ad R)
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Yearly Fitness Adult 240.00 1 .00 0.00 0.00 240.00
Pass Holder: Nidia Escoto
Pass Type: Yly FT Alt Res (YFTAR), #19032 Fees +Tax Discount Prev id Cur Paid Amount Due
r
valid Dates: 01/10/2008 to 01/10/2009 Pass Transfer from Prem. Yrly Ad R)OD 240.00 0.00 0.00
Fee Details: Fee Description
F A mount Count
Yearly Fitness Adult Discount Sales Tax Total Fee
r 240.00 1.00 0.00
0.00 240.00
G /L Code Descri ption
99999 Control Account (AP)— Account Number
Cst �nt� Descri ption
Enter Control Acct CNTRL Account Number
k The REVENUE account was DEB as CREDITED on the day of the refund Amoun
DEBITED and the CONTROL account w Control Account (AP)
Enter Control Acct here t
280.00 DR
Finance will have to DEBIT the CONTROL account for the amounts listed above after
L`
the checks have been written to the customers.
r
j n Processed o 01 /10/08 PREVIOUS NET HO USEHOLD F 13:57:13 by EDR BALANCE
z NET FROM/TO TRANSFER FEES 0.00
DISCOUNT APPLIED AGAINST
NET FROM/TO TRANSFER TAX FEES
280.00
0 .00
NETAMOUNT FQOM CHgNGED1TEN}g 0.00
TOTAL AMO
UNT REFUNDED
NEW NET HOUSEHOLD 280 00
Refund T BALANC
Refund T ype: Refund from Finance
of 280.00
Made By JOURNAL_ 0.00
RF With
Reference
Y r
PASS REFUND RECEIPT
Receipt 83343
Payment Date: 01/10/08
Household 12808
Amount: 480.00 Payment Type: Pass Management Credit Balance
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. o cash or credit card refunds.
Authorized S fu Date Authorized Signature Date
y3 S�k��
zos
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
q Purchase Order No.
Cruz Escoto Terms
14135 Nicholas Dr. Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/10/08 83343 Refund 280.00
Total 280.00
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.
Cruz Escoto Allowed 20
14135 Nicholas Dr.
Westfield, IN 46074
In Sum of
280.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or Board Members
Dept ept INVOICE NO. ACCT #/TITLE AMOUNT
1047 83343 4358400 280.00 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
28 -Feb 2008
Si nawr
280.00 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund