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Home My WebLink About156687 02/21/2008 CITY OF CARMEL, INDIANA VENDOR: T360871 Page 1 of 1 ONE CIVIC SQUARE DAROLD LARSON CARMEL, INDIANA 46032 11050 WINDING BROOK LANG CHECK AMOUNT: $315.43 9 INDIANAPOLIS IN 46260 CHECK NUMBER: 156687 CHECK DATE: 2/2112008 DEPARTMENT ACCOUNT P NUMBER INVOICE NUMBER AM DESCRIPTION 1047 4356400 315.43 PARKS DEPARTMENT REFU i a PASS REFUND RECEIPT Receipt 89172 RECEIVED Payment Date: 02/01/2008 Household 6950 FEB 0 3 2008 Home Phone: (317)575 -1922 Work Phone: (317)695 -3473 DAROLD LARSON Monon Center 11050 WINDING BROOK LANE Carmel IN 46032 INDIANAPOLIS, IN 46280 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Pass Details CANCELLATION Refund Of 315.43 Pass Holder: Darold Larson Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Prem. Yrly HH R (PRMYRHHR), #2941 724.57 0.00 724.57 0.00 0.00 Valid Dates: 05/22/2007 to 05/22/2008 Pass Cancellation) Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee Prem Yrly HH Res 724.57 1.00 0.00 0.00 724.57 Cancel Reason: switching to single adult with CCSD CANCELLATION Pass Holder: Beth Larson Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Prm Yr HH Add R (PRMHHADR), #3035 0.00 0.00 0.00 0.00 0.00 Valid Dates: 05/26/2007 to 05/26/2008 Pass Cancellation) Cancel Reason: switching to single adult with CCSD CANCELLATION Pass Holder: Bryan Larson Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Prm Yr HH Add R (PRMHHADR), #3036 0.00 0.00 0.00 0.00 0.00 Valid Dates: 05/26/2007 to 05/26/2008 Pass Cancellation) Cancel Reason: switching to single adult with CCSD CANCELLATION Pass Holder: Hannah Larson Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Prm Yr HH Add R (PRMHHADR), #3037 0.00 0.00 0.00 0.00 0.00 Valid Dates: 05/26/2007 to 05/26/2008 Pass Cancellation) Cancel Reason: switching to single adult with CCSD Page 1 PASS REFUND RECEIPT Receipt 89172 Payment Date: 02/01/08 Household 6950 CANCELLATION Pass Holder: Carrie Larson Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Prm Yr HH Add R (PRMHHADR), #3038 0.00 0.00 0.00 0.00 0.00 Valid Dates: 05/26/2007 to 05/26/2008 Pass Cancellation) Cancel Reason: switching to single adult with CCSD GIL Code Description Account Number Cst Cntr Descriptio Account Number Amount 999999 Controf Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 315.43 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 02/01/08 08:37:28 by EDR FEES CHANGED ON CANCELLED ITEMS 315.43 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 NET,AMOUNT FROM CANCELL "ED ITEMS 315:43= TOTAL AMOUNT REFUNDED 315.43'' NEW NET HOUSEHOLD BALANCE 0 Refund Type: Refund from Finance Refund of 315. By JOURNAL -RF With Reference All refun are subject to t e Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be iss Na c or credit d ref ds. z1 Author ate Authorized Signature Date L4 Page 9 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. Darold Larson Terms 11050 Winding Brook Lane Date Due Indianapolis, IN 46280 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 2/1/08 89172 Refund 315.43 Total 315.43 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. Darold Larson Allowed 20 11050 Winding Brook Lane Indianapolis, IN 46280 In Sum of 315.43 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 89172 4358400 315.43 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 5 -Feb 2008 r Signatu 315.43 Business Services Manager Cost distribution ledger classification if Title claim paid motor vehicle highway fund