166628 12/10/2008 i
CITY OF CARMEL, INDIANA VENDOR: T362229 Page 1 of 1
ONE CIVIC SQUARE JUDY CLEM
CARMEL, INDIANA 46032 PO BOX 147 CHECK AMOUNT: $32.00
FOUNTAINTOWN IN 46130 CHECK NUMBER: 166628
CHECK DATE: 12/10/2008
DEPARTMENT A CCOUNT PO NUMBER INVOICE NUMBER A DESCRIPTION
1047 4358400 204473 32.00 REFUNDS AWARDS INDE
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i GLOBAL REFUND RECEIPT
Receipt 204473
Payment Date: 11/25/2008
Household 12390
Home Phone: (317)670 -9454 i
Work Phone: (317)275 -4477 NO V 2 5 2008
JUDY CLEM Carmel Clay Parks Recreation
PO BOX 147 1235 Central Park Drive East
FOUNTAINTOWN IN 46130 Carmel IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 32.00- 32.00 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 32.00 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 CREDIT HOUSEHOLD BALANCE 32.00
Processed on 11/25/08 11:06:53 by ABK NEW REFUND AMOUNT 32.0
TOTAL REFUNDABLE AMOUNT 32.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 32.00 Made By REFUND FINAN With Reference Auto renew error
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 Signature Date Authorized Signature Date
4-1
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.
Clem, Judy Terms
P.O. Box 147 Date Due
Fountaintown, IN 46130
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/25/08 204473 Refund 32.00
Total 32.00
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.
Clem, Judy Allowed 20
P.O. Box 147
Fountaintown, IN 46130
In Sum of
32.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or Board Members
Dept
INVOICE NO. ACCT #/TITLE AMOUNT
1047 204473 4358400 32.00 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
5 -Dec 2008
Signature
32.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund