166439 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: T362194 Page 1 of 1
ONE CIVIC SQUARE LORI ZIRKLE
CARMEL, INDIANA 46032 3546 N GOLDEN GATE DRIVE CHECK AMOUNT: $55.00
WESTFIELD IN 46074 CHECK NUMBER: 166439
CHECK DATE: 11/24/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 199337 55.00 REFUNDS AWARDS INDE
t
ACTIVITY REFUND RECEIPT
Receipt 199337��T
Payment Date: 11/05/2008
Household 10118 NOV 1 2 2008
Home Phone: (765)860 -8483
Work Phone:
1b Y:
LORI ZIRKLE Monon Center
3546 N. GOLDEN GATE DRIVE Carmel IN 46032
WESTFIELD IN 46074
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 55.00- 55.00 0.00
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 55.00 DR
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 55.00
Processed on 11/05/08 12:10:46 by LVA NEW REFUND AMOUNT 55.00
TOTAL REFUNDABLE AMOUNT 55.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 55.00 Made By REFUND FINAN With Reference low enrollment
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.
Authorized i nature ate Authorized Signature Date
u 7. W.
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Page 1
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.
Zirkle, Lori Terms
3546 N Golden Gate Drive Date Due
1
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/5/08 199337 Refund 55.00
Total 55.00
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.
Zirkle, Lori Allowed 20
3546 N Golden Gate Drive
Westfield, IN 46074
In Sum of
55.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 199337 4358400 55.00 I 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
17 -Nov 2008
Signature
55.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund