161960 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: T360590 Page 1 of 1
ONE CIVIC SQUARE SHAWNA MOLTER CHECK AMOUNT: $245.90
CARMEL, INDIANA 46032 111 W MAIN STREET APT 3S
CARMEL IN 46032 CHECK NUMBER: 161960
CHECK DATE: 7/2312008
D EPARTMENT ACCOUNT P N UMBER INVOICE NUMBER AMOU DE
1047 4358400 245.90 PARKS DEPARTMENT REFU
i
PASS REFUND RECEIPT
Receipt 149004 R
Payment Date: 07/11/2008 JUL 1 5 2008
Household 18021
Home Phone: (765)714 -1308
Work Phone:, (317) BY:
r
SHAWNA MOLTER Carmel Clay Parks Recreation
t 111 WEST MAIN STREET 1235 Central Park Drive East
APT 3S Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Orio Bal Refund New Bal
Module: Pass Management 245.90- 245.90 0.00
G/L Code Descri Account Number Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 245.90 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 245.90
Processed on 07111/08 12:37:02 by LVA NEW REFUND AMOUNT 245.90
TOTAL REF.,UNDABLE AMOUNT 245.90 7
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 245.90 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. cash or credit card refunds.
P,/, q
z d &Va ure Date Authorized Signature Date
3 ou 3' S
Page 1
ACCOUNTS PAYABLE VOUCHER
c' 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.
Molter, Shawna Terms
r.M 111 W. Main Street Apt 3S Date Due
A Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/11/08 149004 Refund 245.90
Total 245.90
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.
Molter, Shawna Allowed 20
111 W. Main Street Apt 3S
sr Carmel, IN 46032
In Sum of
245.90
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#1TlTLE AMOUNT Board Members
Dept
1047 149004 4358400 245.90 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
18 -Jul 2008
Signature
245.90 Accounts Payable Coordinator
Cost distribution ledger classification if r Title
claim paid motor vehicle highway fund