156155 02/06/2008 CITY OF CARMEL., INDIANA VENDOR: T360815 Page 1 of 1
ONE CIVIC SQUARE CRUZ ESCOTO
CARMEL, INDIANA 46032 14135 NICHOLAS DR CHECK AMOUNT: $480.00
WESTFIELD IN 48074
CHECK NUMBER: 156755
CHECK DATE: 2/6/2008
DEPARTMENT ACCOUNT PQ NUMBER INVO N UMBER AMOUNT DESCRIPTION
1.046 4358400 84463 480.00 REFUNDS AWARDS SNDE
PASS REFUND RECEIPT
f
Receipt 84463
Payment Date: 01/11/2008
Housbhold 12808
Home Phone: (317)566 -0773
Work Phone: (317)406 -2647 JAN 2 2 2008
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I
CRUZ ESCOTO Monon Center
14135 NICHOLAS DR Carmel IN 46032
WESTFIELD, IN 46074
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 240.00
Pass Holder: Cruz ESCOtO Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly FT Alt Res (YFTAR), #19031 0.00 0.00 0.00 0.00 0.00
Valid Dates: 01/10/2008 to 01/10/2009 Pass Cancellation)
Cancel Reason: Change of schedule
CANCELLATION Refund Of 240.00
Pass Holder: Nidia ESCOto Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly FT Alt Res (YFTAR), #19032 0.00 0.00 0.00 0.00 0.00
Valid Dates: 01/10/2008 to 01/10/2009 Pass Cancellation)
Cancel Reason: Change of schedule
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 480.00 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 01/11/08 10:18:00 by EDR FEES CHANGED ON CANCELLED ITEMS 480.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS. 480.00-
TOTAL AMOUNT REFUNDED 480.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund Type: Refund from Finance 1
Refund of 480.00 Made By JOURNAL -RF With Reference
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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.
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
1/11/08 84463 Refund 480.00
Total 480.00
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
480.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 84463 4358400 480.00 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
24 -Jan 2008
i
Si natur
480.00 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund