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162491 08/07/2008 CITY OF CARMEL, INDIANA VENDOR: T361660 Page 1 of 1 ONE CIVIC SQUARE GEOFF SCHROF 0 CHECK AMOUNT: $40.00 CARMEL, INDIANA 46032 2234 PRESIDENT ST CARMEL IN 46032 CHECK NUMBER: 162491 CHECK DATE: 8/7/2008 DEPARTMENT AC COUNT PO NUMBER INVOIC NUMBER AMOUNT DESCRIPTION 1047 4358400 40.00 PARKS DEPARTMENT REFU r, PASS REFUND RECEIPT Receipt 164690 RECEIVED Payment Date: 07/29/2008 Household 4586 AUG 0 d 2008 Home Phone: (317)815 -8999 Work Phone: BY: GEOFF SCHROF Monon Center 2234 PRESIDENT ST Carmel IN 46032 CARMEL IN 46032 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Pass Details CANCELLATION Refund Of 40.00 Pass Holder: Geoff Schrof Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Vu AQ Alt Res10 (VAQAR10), #9385 0.00 0.00 0.00 0.00 0.00 Valid Dates: 07/24/2008 to 12/31/2099 Pass Cancellation) Pass Visit Info: Number of Visits: 11 Cancel Reason: Child bought and mother did not need it. 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 40.00 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 07/29/08 14:19:37 by LVA FEES CHANGED ON CANCELLED ITEMS 40.00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 15NETLYAAOUNT;'FIROM CANCELLEWITEMS 40:00 NEW NET HOUSEHOLD BALANCE 0.00 Refund of 40.00 Made By REFUND FINAN With Reference r nds ar subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be ued. No Zsh or cr dit car refunds. Authorized Signature Date Authorized Signature Date 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. Schrof, Geoff Terms 2234 President St Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoices) or bill(s)) Amount 7/29/08 164690 Refund 40.00 Total 40.00 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. Schrof, Geoff Allowed 20 2234 President St Carmel, IN 46032 -r In Sum of 40.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 164690 4358400 40.00 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 4 -Aug 2008 Signature 40.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund