HomeMy WebLinkAbout164237 09/30/2008 CITY OF CARMEL, INDIANA VENDOR: T361899 Page 1 of 1
ONE CIVIC SQUARE ASHLEY FORSYTH CHECK AMOUNT: $128.00
CARMEL, INDIANA 46032 ass BOYLSTAN ST
CARMEL IN 46032 CHECK NUMBER: 164237
CHECK DATE: 9/30/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 128.00 REFUNDS AWARDS INDE
I
ri
y �t PASS REFUND RECEIPT
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Receipt# 186361
Payment Date: 09/08/2008
Household 14653
Home Phone: (479)621 -3934
Work Phone: (317)
i ASHLEY FORSYTH Monon Center
356 BOYLSTAN ST Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 128.00
Pass Holder: Ashley Forsyth Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prem. Yrly Ad R (PRMYRADR), #18371 64.00 0.00 64.00 0.00 0.00
Valid Dates: 01/02/2008 to 01/02/2009 Pass Cancellation)
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Prem. Yearly Adult R 64.00 1.00 0.00 0.00 64.00
Cancel Reason: forsyth
G/L Code Description Account N Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 128.00 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 e h 32.00
Processed on 09108/08 17:25:40 by EMB FEES CHANGED ON CANCELLED ITEMS "a, 160.00
DISCOUNT APPLIED AGAINST CANCELLED FEES( 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
`NET AMOUNT. FROM;CANCELLEDzITEMS" 160:00 =v
HH BALANCE APPLIED TO THIS RECEIPT 32.00
TOTAL AMOUNT REFUNDED 128:00:;
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 128.00 Made By REFUND FINAN With Reference
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.
Al
L I O-T�
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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.
Forsyth, Ashley Terms
356 Boylstan St Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number or note attached invoice's) or bill's)) Amount
9/8/08 186361 Refund 128.00
I
Total 128.00
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.
Forsyth, Ashley Allowed 20
356 Boylstan St
Carmel, IN 46032
In Sum of
128.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 186361 4358400 128.00 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
24 -Sep 2008
Signature
128.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund