HomeMy WebLinkAbout159437 05/14/2008 CITY OF CARMEL, INDIANA VENDOR: T361257 Page 1 of 1
ONE CIVIC SQUARE ROB KIRSH
j CHECK AMOUNT: $118.50
6084 APPLE TREE DR SUITE 1
CARMEL, INDIANA 46032 MEMPHIS TN 38115 CHECK NUMBER: 159437
CHECK DATE: 5/14/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 118.50 REFUNDS AWARDS INDE
PASS REFUND RECEIPT
Receipt 109977
Payment Date: 04/23/2008
Household 6175 AwN 9, 9 zppg
Home Phone: (901)825 -3960
Work Phone: (317)557 -2000
BY:
ROB KIRSH Carmel Clay Parks Recreation
6084 APPLE TREE DR. SUITE 1 1235 Central Park Drive East
MEMPHIS TN 38115 Carmel IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 73.50
Pass Holder: Rob Kirsh Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Vu KZ Mem50 (VKZM50), #21357 1.50 0.00 1.50 0.00 0.00
Valid Dates: 02/23/2008 to 12/31/2099 Pass Cancellation)
Pass Visit Info: Number of Visits: 49
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Value KidZone Member 1.50 1.00 0.00 0.00 1.50
Cancel Reason: Moving to Tennessee
CANCELLATION Refund Of 45.00
Pass Holder: Amy Kirsh Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Vu MC Alt Rasl0 (VMCAR10), #21358 5.00 0.00 5.00 0.00 0.00
Valid Dates: 02/23/2008 to 12/31/2099 Pass Cancellation)
Pass Visit Info: Number of Visits: 9
Fee Details: Fee Description Amount C ount Discount Sales Tax Total Fee
Value MC Alt Res 10 5.00 1.00 0.00 0.00 5.00
Cancel Reason: Moving to Tennessee
GIL Code Description Account Number Cst Cntr Description Acco Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 118.50 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 04/23/08 05:30:05 by LVA FEES CHANGED ON CANCELLED ITEMS 118.50
DISCOUNT APPLIED AGAINST CANCELLED FEES O 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET,AIIIIOUNT.:PROM CANCELLED =ITEMS 118.50
"TOTAL"AMOUN- r6REF.UNDED
Page 1
PASS REFUND RECEIPT
Receipt 105977
Payment Date: 04123(08
Household 6175
NEW NET HOUSEHOLD BALANCE 0.00
'Refund of 118.50 Made By JOURNAL -RF With Reference cancel passes
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issue No cash or c dit card refunds.
A thorized gnat Date Authorized Signature Date
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.
Terms
Rob Kirsh
6084 Apple Tree Dr., Ste 1 Date Due
Memphis, TN 38115
Invoice Invoice Description
Amount
Date Number (or note attached invoice(s) or bill(s))
118.50
4123/08 109977 Refund
Total 118.50
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Rob Kirsh Allowed 20
6084 Apple Tree Dr., Ste 1
Memphis, TN 38115
In Sum of
118.50
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO #or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1047 109977 4358400 118.50 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
1 -May 2008
nat re
118.50 Business S y i s Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund