165218 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: T362044 Page 1 of 1
ONE CIVIC SQUARE ELISA FELIPE CHECK AMOUNT: $7.50
CARMEL, INDIANA 46032 13921 WASHITA CT
CARMEL IN 46032 CHECK NUMBER: 165218
CHECK DATE: 10/29/2008
DEPARTMENT ACC OUNT PO NUMB INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 192211 7.50 REFUNDS AWARDS INDE
F
g F
b` 4 P t
ACTIVITY REFUND RECEIPT
Receipt 192211 �v+
Payment Date: 10/06/2008
Household 21342
Home Phone: (317)581 -1271 OCT 1 4 2008
Work Phone: (317)645 -5249
BY:
ELISA FELIPE Monon Center
13921 WASHITA CT Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Orio Bal Refund New Bal
Module: Activity Registration 7.50- 7.50 0.00
G/L Cod Des cription_______._ Account Number Cst Cntr Description Account Number Amou
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 7.50 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 7.50
Processed on 10/06/08 10:57:03 by LVA NEW REFUND AMOUNT 7.50
TOTAL REFUNDABLE AMOUNT 7.50
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 7.50 Made By REFUND FINAN With Reference instructor cancelled
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issu No cash or credit card refunds.
r
1 Authorized I ature Date Authorized Signature Date
H 30. 300,
4ip Hop I V s Iry CA-a r cc-gnu-IL ckag 5
Page 1
t ACCOUNTS PAYABLE VOUCHER
r 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.
Felipe, Elisa Terms
13921 Washita Ct Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/6/08 192211 Refund 7.50
Total 7.50
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.
Felipe, Elisa Allowed 20
13921 Washita Ct
Carmel, IN 46032
In Sum of
7.50
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 192211 4358400 7.50 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
15 -Oct 2008
I
r
Signature
7.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund