161212 07/08/2008 CITY OF CARMEL, INDIANA VENDOR: T361490 Page 1 of 1
ONE CIVIC SQUARE STACY GRUEN CHECK AMOUNT: $196.00
o CARMEL, INDIANA 46032 85 WILLIAMSBURG CT
ZIONSVILLE IN 46077 CHECK NUMBER: 161212
CHECK DATE: 7/8/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 129446 196.00 REFUNDS AWARDS INDE
PASS REFUND RECEIPT
Receipt 129446 TVF:D
Payment Date: 06/12/2008
Household 13014 JUN 2 3 2008
Home Phone: (317)732 -4112
Work Phone: gar.
STACY GRUEN Carmel Clay Parks Recreation
85 WILLIAMSBURG COURT 1235 Central Park Drive East
ZIONSVILLE IN 48077 Carmel IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 128.00
Pass Holder: Stacy Gruen Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Seas AQ Adt Non (SAQAN), #18850 0.00 0.00 0.00 0.00 0.00
Valid Dates: 05/26/2007 to 09/03/2007 Pass Cancellation)
Cancel Reason: moving
CANCELLATION Refund Of 68.00
Pass Holder: Julia Gruen Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Seas AQ Yth Non (SAQYN), #18851 0.00 0.00 0.00 0.00 0.00
Valid Dates: 05/26/2007 to 09/03/2007 Pass Cancellation)
Cancel Reason: moving
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 196.00 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 06/12/08 10:19:33 by LVA FEES CHANGED ON CANCELLED ITEMS 196.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET.`AMOUNT'FROM °;CANCELLED ITEMS s 196:00=
;TOTAL-AMOUNT REF.UNDED,, 196.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 196.00 Made By JOURNAL -RF With Reference
Page 1
PASS REFUND RECEIPT
Receipt 129446
Payment Date: 06/12/08
Household 13014
A�ds are ubject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
is d sh or credit card refunds.
Auth ed ignature Date Authorized Signature Date
1305. 7 `f
Page #2
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.
Gruen, Stacy Terms
85 Williamsburg Court Date Due
Zionsville, IN 48077
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/12/08 129446 Refund 196.00
Total 196.00
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.
Gruen, Stacy Allowed 20
85 Williamsburg Court
Zionsville, IN 48077
In Sum of
196.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 129446 4358400 196.00 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
27 -Jun 2008
Signature
196.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
ENMED