166308 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: T362187 Page 1 of 1
ONE CIVIC SQUARE MARTIN MEISENHEIMER CHECK AMOUNT: $60.00
CARMEL, INDIANA 46032 471 BURLINGTON LANE
CARMEL IN 46032 CHECK NUMBER: 166308
CHECK DATE: 11/24/2008
DEPARTMENT AC COUN T PO NUMBER INVOICE N UMBER AMOUNT DESC RIPTION
1047 4358400 197142 60.00 REFUNDS AWARDS INDE
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PASS REFUND RECEIPT
Receipt 197142
Payment Date: 10/27/2008T T
Household 4641
Home Phone: (317)844 -3920
Work Phone: (317)962 -6300 00V 2 2008
BY:
�N
MARTIN MEISENHEIMER Monon Center
471 BURLINGTON LANE Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
MEMBERSHIP CHANGE Refund Of 30.00
Pass Holder: Jill Meisenheimer Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: PT half hour (VPTHAL), #30667 0.00 0.00 0.00 0.00 0.00
Valid Dates: 09/02/2008 to 12/31/2099 Pass Change)
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Personal Training 0.00 1.00 0.00 0.00 0.00
MEMBERSHIP CHANGE Refund Of 30.00
Pass Holder: Jill Meisenheimer Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: PT half hour (VPTHAL), #38998 0.00 0.00 0.00 0.00 0.00'
Valid Dates: 09/09/2008 to 12/31/2099 Pass Change)
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Personal Training 0.00 1.00 0.00 0.00 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 60.00 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 10/27/08 12:25:38 by EMB FEES ADJUSTED ON CHANGED ITEMS 60.00
DISCOUNT APPLIED AGAINST THESE FEES 0.00
SALES TAX CHARGED ON CHANGED FEES 0.00
NET AMOUNT FROM:CHANGED ITEMS 60.00
TOTAL AMOUNTREFUNDED 60.00
NEW NET HOUSEHOLD BALANCE 0.00
Page 1
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PASS REFUND RECEIPT
Receipt 197142
Payment Date: 10/27/2008
Household 4641
ss
Refund of 60.00 Made By REFUND FINAN With Reference
:iAII 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.
D Tis R, uK
Authorized dignature Date Authorized Signature Date
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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
Purchase Order No.
Meisenheimer, martin Terms
471 Burlington Lane Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/27108 197142 Refund 60.00
Total 60.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Meisenheimer, martin Allowed 20
471 Burlington Lane
Carmel, IN 46032
In Sum of
60.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 197142 4358400 60.00 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
17 -Nov 2008
1 �moxl /V-7 J
Signature
v
60.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund