155304 01/10/2008 CITY OF CARMEL, INDIANA VENDOR: 360699 Page 1 of 1
ONE CIVIC SQUARE KEVIN GARTENHAUS
CHECK AMOUNT: $959.40
CARMEL, INDIANA 46032 1196 HELFORD LANE
CARMEL IN 46032 CHECK NUMBER: 155304
CHECK DATE: 1/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 76401 959.40 REFUNDS AWARDS INDE
k
PASS REFUND RECEIPT
Receipt 76401
Payment Date: 12/1412007
Household 7054
Home Phone: (317)581 -1512
Work Phone: (317)407 -6388 ((''''fi� n �Ou7
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KEVIN GARTENHAUS Monon Center
1196 HELFORD LANE Carmel IN 46032
CARMEL, IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION
Pass Holder: Kevin Gartenhaus Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prem. Yrly HH R (PRMYRHHR), #3185 0.00 0.00 0.00 0.00 0.00
Valid Dates: 05/24/2007 to 05/24/2008 Pass Cancellation)
CANCELLATION
Pass Holder: Kelly Gartenhaus Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prm Yr HH Add R (PRMHHADR), #3187 0.00 0.00 0.00 0.00 0.00
Valid Dates: 05/24/2007 to 05/24/2008 Pass Cancellation)
CANCELLATION Refund Of 959.40
Pass Holder: Matthew Gartenhaus Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prm Yr HH Add R (PRMHHADR), #3188 80.60 0.00 80.60 0.00 0.00
Valid Dates: 05/26/2007 to 05/26/2008 Pass Cancellation)
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Prem Yrly HH Res 80.60 1.00 0.00 0.00 80.60
CANCELLATION
Pass Holder: Zachary Gartenhaus Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prm Yr HH Add R (PRMHHADR), #3189 0.00 0.00 0.00 0.00 0.00
Valid Dates: 05/26/2007 to 05/26/2008 Pass Cancellation)
Page 1
PASS REFUND RECEIPT
Receipt 76401
Payment Date: 12/14/07
Household 7054
CANCELLATION
Pass Holder: Lauren GartenhaUs Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prm Yr HH Add R (PRMHHADR), #3190 0.00 0.00 0.00 0.00 0.00
Valid Dates: 05/24/2007 to 05/24/2008 Pass Cancellation)
GIL 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 959.40 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 12/14/07 09:09:14 by EDR FEES CHANGED ON CANCELLED ITEMS 959.40
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
aNET ;AMOUNT'EROMECANCELLEbilTEMS 959'40'
i,TLOTAL AMQUNT''REFUNDEDr 95940}
NEW NET HOUSEHOLD BALANCE 0.00
Refund Type: Refund from Finance
Refund of 959.40 Made By JOURNAL -RF With Reference
All refunds a subjqmto Stat5Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
iss lalo cash or r dit rd refunds.
Authorize ignature Date Authorized Signature Date
Page #2
ACCOUNTS PAYABLE VOUCHER
s' 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.
Kevin Gartenhaus Terms
1196 Helford Lane Date Due
Carmel IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/14/07 1 76401 Refund 959.40
Total 959.40
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.
Kevin Gartenhaus Allowed 20
1196 Helford Lane
Carmel IN 46032
In Sum of
959.40
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 76401 4358400 959.40 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
4 -Jan 2008
Sign to
959.40 Busin Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund