HomeMy WebLinkAbout166382 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: T362191 Page 1 of 1
ONE CIVIC SQUARE MICHELLE SHADRICK CHECK AMOUNT: $219.17
CARMEL, INDIANA 46032 3621 EDEN PLACE
CARMEL IN 46033 CHECK NUMBER: 166382
CHECK DATE: 11/24/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 199489 219.17 REFUNDS AWARDS INDE
�1
PASS REFUND RECEIPT
Receipt 199489
Payment Date: 11/06/2008
Household 8375
Home Phone: (317)581 -9698 �OV 2 2008
Work Phone:
BY
MICHELLE SHADRICK Monon Center
3621 EDEN PLACE Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 219.17
Pass Holder: Shelby Shadrick Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly GF Res Unli (YGFRU), #40080 30.83 0.00 30.83 0.00 0.00
Valid Dates: 09/22/2008 to 09/22/2009 Pass Cancellation)
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Yearly GF Res Unlimi 30.83 1.00 0.00 0.00 30.83
Cancel Reason: mono
GIL Code Description Account Number C st Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 219.17 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 11/06/08 08:54:55 by RDG FEES CHANGED ON CANCELLED ITEMS 219.17
DISCOUNT APPLIED AGAINST CANCELLED FEES O 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
°NET'AMOUNl.'.F,ROM;CANCELLED ITEMS"— -219:1,7':
TOTAL`AMOUNT�REFUNDEDa- F<u�
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 219.17 Made By REFUND FINAN With Reference
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. No cash or credit card refunds.
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Authorized Signature Date Authorized Signature Date
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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.
t S
Shadrick, Michelle Terms
3621 Eden Place Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1116108 199489 Refund 219.1
Total 219.17
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