164347 09/30/2008 CITY OF CARMEL, INDIANA VENDOR: 00351993 Page 1 of 1
ONE CIVIC SQUARE MICHELLE T MILLER
CARMEL, INDIANA 46032 12517 -10 TIMBER CREEK DR CHECK AMOUNT: $20.00
CARMEL IN 46032
CHECK NUMBER: 164347
CHECK DATE: 9/30/2008
Df PART MENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 20.00 REFUNDS AWARDS INDE
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PASS REFUND RECEIPT
Receipt 181606
Payment Date: 08/28/2008
Household 11419
Home Phone: (317)374 -6262 REC W'FID
Word: Phone:
SEP 2 3 2008
BY:
MICHELLE MILLER Monon Center
12517 TIMBER CREEK DR. Carmel IN 46032
#10
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
I
Pass Details
MEMBERSHIP CHANGE Refund Of 20.00
Pass Holder: Michelle. Miller Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly FT Alt Res (YFTAR), #20633 20.00 0.00 20.00 0.00 0.00
Valid Dates: 08/11/2008 to 02/05/2010 Pass Change)
Auto -Debit Details: 1 Current/Previous Bill(s) Totaling $20.00 17 Future Bill(s) Totaling $340.00
Final Cumulative Fees Totaling $360.00
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Yearly Fitness Adult 20.00 1.00 0.00 0.00 20.00
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 20.00 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 08/28/08 12:46:10 by EMB FEES ADJUSTED ON CHANGED ITEMS 20.00-
1 DISCOUNT APPLIED AGAINST THESE FEES 0.00
SALES TAX CHARGED ON CHANGED FEES 0.00
NETxAMOUNT FROM CHANGEDITEMS 20:00
"TOTAL''AMOU NT-RE FUNDED
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 20.00 Made By REFUND FINAN With Reference Michelle Miller
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.
P/W" �J f av
Authorized 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.
Miller, Michelle Terms
12517 Timber Creek Dr., 10 Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/28/08 181606 Refund 20.00
Total 20.00
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.
Miller, Michelle
Allowed 20
12517 Timber Creek Dr., 10
Carmel, IN 46032 In Sum of
20.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
Dept
1047 181606 4358400 20.00 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 -Sep 2008
Signature
20.00 Accounts Payable Coordinator
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund