160025 05/28/2008 f CITY OF CARMEL, INDIANA VENDOR: T361292 Page 1 of 1
ONE CIVIC SQUARE LAURA PERKINS CHECK AMOUNT: $200.00
CARMEL, INDIANA 46032 13179 HAZELWOOD DR
CARMEL IN 46033 CHECK NUMBER: 160025
CHECK DATE: 5/28/2008
DEPARTMENT ACCOUNT PO NUMBER INVOI NUM AMOUNT DESCRIPTION
1047 4358400 114987 200.00 REFUNDS AWARDS INDE
I
I
PASS REFUND RECEIPT
r.
Receipt 114987
Payment Date: 05/12/2008 C�'T�J'�"i D
Household 2135
Home Phone: (317)846 -6307 MAY 1 5 2008
Work Phone: (317)277 -0989
LAURA PERKINS Carmel Clay Parks Recreation
13179 HAZELWOOD DR. 1235 Central Park Drive East
CARMEL IN 46033 Carmel IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 200.00
Pass Holder: Ethan Perkins Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Private Swim Le (1ON1SWIM), #22899 0.00 0.00 0.00 0.00 0.00
Valid Dates: 04/03/2008 to 04/15/2099 Pass Cancellation)
Pass visit Info: Number of Visits: 10
Cancel Reason: mom was not happy with customer service
G/L Code Description Account Number Cst Cntr Descri Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 200.00 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 CREDIT HOUSEHOLD BALANCE 20.00
Processed on 05/12/08 13:08:38 by ALC FEES CHANGED ON CANCELLED ITEMS 200.00-
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET,ArviOUNT'FROMrCANCELLED ITEh7S" a 200.00
TOTAbAMOUNT REFUNDED
NEW NET CREDIT HOUSEHOLD BALANCE 20.00
Refund of 200.00 Made By JOURNAL -RF With Reference
All refunds are subject to State Board of Accounts claim procedure and may weeks t process. A check will be
issued. No cash or credit card refunds.
Au orize i ature hate Authorized Sig Pure ate
Page 1
1.
Xf 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.
Perkins, Laura Terms
13179 Hazelwood Drive Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/12/08 114987 Refund 200.00
Total 200.00
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.
I Perkins, Laura Allowed 20
13179 Hazelwood Drive
Carmel, IN 46033
In Sum of
200.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 114987 4358400 200.00 1 hereby certify that the attached invoice(s), or
bills) 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
Sign,
200.00 Business Services Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund