164725 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: T359397 Page 1 of 1
ONE CIVIC SQUARE MICHELLE GOYER
CARMEL, INDIANA 46032 13896 SALSBURY CREEK DRIVE CHECK AMOUNT: $116.00
CARMEL IN 46032
CHECK NUMBER: 164725
CHECK DATE: 10/16/2008
DEPARTMENT ACCOUNT P O NUMBER INVOICE NUMBER A MOUNT DESCRIPTION
1047 4358400 193241 116.00 REFUNDS AWARDS INDE
U
ACTIVITY REFUND RECEIPT
Receipt 193241
Payment Date: 10/09/2008
Household 808 -I C
Home Phone: (317)815 -1288
Work Phone: (317)684 -3720 OCT 9 2008
BY
MICHELLE GOYER Monon Center
13896 SALSBURY CREEK DR. Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 116.00 116.00 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 116.00 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 HOUSEHOLD BALANCE 116.00
Processed on 10/09/08 15:02:20 by KAS NEW REFUND AMOUNT 116.00
,TOTAL";REFUN DAB LE AMOUNT. ;116 00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 116.00 Made By REFUND FINAN With Reference
All refunds a subject t S ate Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. cash r cred t c rd r n
Authorize Sig Date Authorized Signature Date
4
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.
Goyer, Michelle Terms
13896 Salsbury Creek Dr Date Due
Carmel, IN 46032
4
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/9/08 193241 Refund 116.00
Total 116.00
I 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.
Goyer, Michelle Allowed 20
13896 Salsbury Creek Dr
Carmel, IN 46032
In Sum of
ac 116.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 193241 4358400 116.00 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
10 -Oct 2008
Signature
116.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund