159879 05/28/2008 CITY OF CARMEL, INDIANA VENDOR: T361291 Page 1 of 1
ONE CIVIC SQUARE CAROLYNN FOWLER
0 CHECK AMOUNT: $308.00
�G' CARMEL, INDIANA 46032 15720 BOLTON CIRCLE
WESTFIELD IN 46074 CHECK NUMBER: 159879
CHECK DATE: 5/28/2008
DEPARTMENT ACCOUNT PO N UMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 116557 308.00 REFUNDS AWARDS INDE
1
Payment Date: 05/15/2008
Household 16072
Home Pho'a: (3'!7)867 -1444
Wol R'Phone,:
CAROLYNN FOWLER Carmel Clay Parks Recreation
15720 BOLTON CIRCLE 1235 Central Park Drive East
WESTFIELD IN 46074 Carmel IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 308.00
Pass Holder: Carolynn Fowler Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Seas AQ HH Non (SAQHN), #23741 0.00 0.00 0.00 0.00 0.00
Valid Dates: 0512412008 to 09/01/2008 Pass Cancellation)
Cancel Reason: moving
CANCELLATION
Pass Holder: Sean Fowler Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Ses AQ HH NonAD (SAQHNADD), #23742 0.00 0.00 0.00 0.00 0.00
Valid Dates: 05/24/2008 to 09/01/2008 Pass Cancellation)
Cancel Reason: moving
CANCELLATION
Pass Holder: Connor Fowler Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Ses AQ HH NonAD (SAQHNADD), #23743 0.00 0.00 0.00 0.00 0.00
Valid Dates: 05/24/2008 to 09/01/2008 Pass Cancellation)
Cancel Reason: moving
CANCELLATION
Pass Holder: Claudia Fowler Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Ses AQ HH NonAD (SAQHNADD), #23744 0.00 0.00 0.00 0.00 0.00
Valid Dates: 05/24/2008 to 09/01/2008 Pass Cancellation,)
Cancel Reason: moving EBY'- '�f R"
2008
Page 1
PASS REFUND RECEIPT
Receipt 116557
Payment Date: 05/15/08
Household 16072
CANCELLATION
Pass Holder: Karlye Fowler Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Ses AQ HH NonAD (SAQHNADD), #23745 0.00 0.00 0.00 0.00 0.00
Valid Dates: 05/24/2008 to 09/01/2008 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 308.00 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 05/15/08•@ 16:43:50 by LVA FEES CHANGED ON CANCELLED ITEMS 308.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNTFROM °CANCECLEDITEMS:a:30800
TOTAL AMOUNT'REFl9NDED:,• 308100
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 308.00 Made By JOURNAL -RF With Reference
All refu subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
iss NO ca h or credit card refunds.
��r a 0 S -ZI -v"
Authonzed Signature Date Authorized Signature Date
14-4 15
PviAY v 2008
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.
Fowler, Carolynn Terms
15720 Bolton Circle Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/15/08 116557 Refund 308.00
Total 308.00
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.
Fowler, Carolynn Allowed 20
15720 Bolton Circle
Westfield, IN 46074
In Sum of
0
308.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 116557 4358400 308.00 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
23 -May 2008
de ez-�
Signature
308.00 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund