164755 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: T361993 Page 1 of 1
ONE CIVIC SQUARE KELLY HOPSON
CARMEL, INDIANA 46032 331 FIRST AVE NW
CHECK AMOUNT: $180.00
,s� APT 2 CHECK NUMBER: 164755
CARMEL IN 46032
CHECK DATE: 10/16/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4358400 189749 180.00 REFUNDS AWARDS INDE
I
PASS REFUND RECEIPT
Rer_zipt 189749 �E -1vF,D
Payment Date: 09/22/2008
Household 11375 S E P .1 U 2008
Home Phone: (317)989 -4210
Work Phone: (317)566 -0104
BY:
KELLY HOPSON Carmel Elementary
331 FIRST AVE NW APT. 2 101 4th Avenue SE
CARMEL IN 46032 Carmel IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
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 168.00 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 180.00
Processed on 09/22/08 18:23:28 by SLH NEW REFUND AMOUNT 180.00
TOTAL REFUNDABLE AMOUNT 180.00
NEW NET CREDIT HOUSEHOLD BALANCE 12.00
Refund of 168.00 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
issued. o cash or credit card refunds.
Authori Signature Date Authorized Signature Date
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.
Hopson, Kelly Terms
331 First Ave NW Apt 2 Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/22/08 189749 Refund 180.00
Total Is 180.00
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.
Hopson, Kelly Allowed 20
331 First Ave NW Apt 2
Carmel, IN 46032
In Sum of
180.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#fTITLE AMOUNT Board Members
Dept
1046 189749 4358400 180.00 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
7 -Oct 2008
Signature
180.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund