158622 05/14/2008 CITY OF CARMEL, INDIANA VENDOR: T361269 Page 1 of 1
j t ONE CIVIC SQUARE JEFF STRETCH
CARMEL, INDIANA 46032 12530 MEETING HOUSE RD CHECK AMOUNT: $209.63
CARMEL IN 46032
CHECK NUMBER: 159622
CHECK DATE: 5/14/2006
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT D
1047 4358400 109905 209.63 REFUNDS AWARDS INDE
i
I
i
r
PASS REF'CIND RECEIPT
9
1
Receipt 109905 RECETVIFID
Payment Date: 04/22/2008
Household 15584 APR 2 9 Z0�$
Home Phone: (317)816 -1408
Work Phone:
BY:
JEFF STREICH Monon Center
12530 MEETING HOUSE ROAD Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 209.63
Pass Holder Jeff Streich Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly AQ Alt Res (YAQAR), #19965 65.37 0.00, 65.37 0.00 0.00
Valid Dates: 01/26/2008 to 01/26/2009 Pass Cancellation)
Fee Details: Fee D A mount C ount Dis count Sa les Tax Total Fee
Yearly Aquatics Adul 65.37 1.00 0.00 0.00 65.37
Cancel Reason: moving to minneapolis
GI Code Descrip Acc ount Number Cst Cntr Description Account Number Amou
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 209.63 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 04/22/08 12:10:17 by TLP FEES CHANGED ON CANCELLED ITEMS 209.63
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS
TOTAL AMOUNT AMOUNT REFUNDED 209.63
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 209.63 Made By JOURNAL -RF With Reference pass cancel
All refunds -e ject to tate Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issu cash or credit card refunds.
Author" gn ture 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.
Jeff Streich Terms
12530 Meeting House Rd Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/22/08 109905 Refund 209.63
Total 209.63
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.
c Jeff Streich Allowed 20
12530 Meeting House Rd
Carmel, IN 46032
In Sum of
209.63
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#rrITLE AMOUNT Board Members
Dept
1047 109905 4358400 209.63 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
Signa re
209.63 Business S rvi es Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund