160439 06/10/2008 CITY OF CARMEL, INDIANA VENDOR: T361381 Page 1 of 1
0 ONE CIVIC SQUARE KATHERINE KORB
CARMEL, INDIANA 46032 9722 JUPITER PASS CHECK AMOUNT: $56.00
'ti ion co:r CARMEL IN 46032 CHECK NUMBER: 160439
CHECK DATE: 6 /10 12008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 117058 56.00 REFUNDS AWARDS INDE
PASS REFUND RECEIPT
Receipt 117058
Payment Date: 05/19/2008
Household 4752
Home Phone: (317)228 -9232
Work Phone: (317)388 -5476
KATHERINE KORB Carmel Clay Parks Recreation
9722 JUPITER PASS rn�Y 1235 Central Park Drive East
CARMEL IN 46032 4 7 200$ Carmel IN 46032
�r Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details.
CANCELLATION Refund Of 56.00
Pass Holder: Katherine Korb Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly GF Res Unli (YGFRU), #13260 194.00 0.00 194.00 0.00 0.00
Valid Dates: 08/09/2007 to 08/09/2008 Pass Cancellation)
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Yearly GF Res Unlimi 194.00 1.00 0.00 0.00 194.00
Cancel Reason: Moving
G/L Code Description Account Number Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 56.00 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 HOUSEHOLD BALANCE 0.00
Processed on 05119/08 10:28:18 by EMB FEES CHANGED ON CANCELLED ITEMS 56.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT ^FROMCANCELLED; ITEMS ,mow:; 56.00
TOTAL'AMOUNTcREFUNDED x 56:00;
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 56.00 Made By JOURNAL -RF With Reference Katherine Korb
All ref re subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
i No ash or credit card refunds.
Authorized ignature Date Authorized Signature Date
3� Z o 3N
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.
Korb, Katherine Terms
9722 Jupiter Pass Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/19/08 117058 Refund 56.00
Total 56.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
.Korb, Katherine Allowed 20
9722 Jupiter Pass
Carmel, IN 46032
In Sum of
56.00
ON ACCOUNT OF APPROPRIATION FOR
104.- Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 117058 4358400 56.00 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
6 -Jun 2008
Signature
56.00 Business Service Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund