163290 09/03/2008 CITY OF CARMEL INDIANA VENDOR: T361795 Page 1 of 1
ONE CIVIC SQUARE MIKE LYONS
CARMEL, INDIANA 46032 15229 SMITHFIELD CHECK AMOUNT: $330.60
WESTFIELD IN 46074
CHECK NUMBER: 163290
CHECK DATE: 9/3/2008
DE PARTMENT ACC OUNT P NUMBER INVOICE NUMBER A DESCRIPTION
1047 4358400 181168 330.60 REFUNDS AWARDS INDE
PASS REFUND RECEIPT
ECFIVR
Receipt 181168
Payment Date: 08/26/2008 UG 2
R A
Household 13855 2008
Home Phone: (317)846 -4888
Work Phone: By
Monon Center
Carmel IN 46032
die t G1� r\J Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
MEMBERCuiD rHANGE Refund Of 330.60
Pass Holder: Michael Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prem. Yrly HH R (PRMYRHHR), #17106 82.65 0.00 82.65 0.00 0.00
Valid Dates: 12/07/2007 to 12/07/2008 Pass Cancellation)
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Prem Yrly HH Res 82.65 1.00 0.00 0.00 82.65
G/L Code Description Account Numb Cntr Descri Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 330.60 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 08/26/08 15:03:46 by EDR FEES ADJUSTED ON CHANGED ITEMS 330.60
DISCOUNT APPLIED AGAINST THESE FEES 0.00
SALES TAX CHARGED ON CHANGED FEES 0.00
NET AMOUNT`FROM CHANGED ITEMS',' 330.60
TOTAL AMOUNT REFUNDED' 330.6014
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 330.60 Made By REFUND FINAN With Reference
All refun subject to S to Board f Accounts claim procedure and may take 4 -6 weeks to process. check w II be
issued. No ash or re card ref n
orized S e Date Authorized Signature Date
L4 1 L4
Page 1
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.
Lyons, Mike Terms
15229 Smithfield Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/26/08 181168 Refund 330.60
Total 330.60
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.
Lyons, Mike Allowed 20
15229 Smithfield
Westfield, IN 46074
n Sum of
330.60
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 181168 4358400 330.60 i 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
28 -Aug 2008
Signature
330.60 Accounts ''ayable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund