159033 04/30/2008 a CITY OF CARMEL, INDIANA VENDOR: 360624 Page 1 of 1
0 t�. ONE CIVIC SQUARE TESS PINTER
CARMEL, INDIANA 46032 4683 GRAND HAVEN LANE, APT H CHECK AMOUNT: $64.78
INDIANAPOLIS IN 46280 CHECK NUMBER: 159033
CHECK DATE: 4/30/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 64.78 WATER OVERPAYMENT REF
Li
I
i,
PASS REFUND RECEIPT
receipt 108930
ayment Date: 04/17/2008
ousehold 5727
ome Phone: (317)288 -0373
/ork, Phone: _ECEI ED
APR 2 3 ZODB
TESS PINTER Monon Center
4683 GRAND HAVEN LN APT H Carmel IN 46032
INDIANAPOLIS IN 46280
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
'ass Details
CANCELLATION Refund Of 64.78
Pass Holder: Michael Pinter Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prem. Yrly Ad R (PRMYRADR), #11028 239.22 0.00 239.22 0.00 0.00
Valid Dates: 07/04/2007 to 07/04/2008 Pass Cancellation)
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Prem. Yearly Adult R 239.22 1.00 0.00 0.00 239.22
Cancel Reason: part-time employee pass now in effect
G/L Code Description Account Number Cs Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 64.78 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 04/17/08 10:06:33 by CEK FEES CHANGED ON CANCELLED ITEMS 64.78
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNTFROM =CANCELLED ITEMS 64 78
TOTAL`AMOUNT REFUNDED 64 78
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 64.78 Made By JOURNAL -RF With Reference part-time employee
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 week process. A check will be
issued. No cash or credit card refunds.
a t ,L1
Authorized Signature Date Aut�iorized Sign ure Date
I Page 1
ter'
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.
Tess Pinter Terms
4683 Grand Haven Ln Apt H Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/17/08 108930 Refund 64.78
Total 64.78
I 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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Tess Pinter Allowed 20
4683 Grand Haven Ln Apt H
Indianapolis, IN 46280
In Sum of
64.78
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#/T1TLE AMOUNT Board Members
Dept
1047 108930 4358400 64.78 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 -Apr 2008
Signature
B
64.78 sine �qna
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund l;