HomeMy WebLinkAbout179163 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 363550 Page 1 of 1
ONE CIVIC SQUARE NATALIE CLARK CHECK AMOUNT: $82.00
CARMEL, INDIANA 46032 728 PRAIRIE DRIVE
BROWNSBURG IN 46112 CHECK NUMBER: 179163
CHECK DATE: 11/11/2009
r
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 350896 82.00 REFUNDS AWARDS INDE
PASS REFUND RECEIPT
Receipt 350896
Payment Date: 11/04/09
r Household 1484
Carmel Clay Parks Recreation Natalie Clark Hm Ph: (317)918 -1835
1235 Central Park Drive East 728 Prairie Drive
Carmel IN 46032 Brownsburg IN 46112 Cell Ph:
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 82.00
Pass Holder: Natalie Clark Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly AQ Hh (YAQHR), #73711 28.00 0.00 0.00 28.00 0.00
Valid Dates: 06/29/2009 to 06/29/2010 Pass Cancellation)
CANCELLATION
Pass Holder: WIII Clark Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly AQ HH Addl (YAQHRADD), #73712 0.00 0.00 0.00 0.00 0.00
Valid Dates: 06/29/2009 to 06/29/2010 Pass Cancellation)
CANCELLATION
Pass Holder: Josie Clark Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly AQ HH Add[ (YAQHRADD), #73713 0.00 0.00 0.00 0.00 0.00
Valid Dates: 06/29/2009 to 06/29/2010 Pass Cancellation)
CANCELLATION
Pass Holder: Georgia Clark Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly AQ HH Addl (YAQHRADD), #73714 0.00 0.00 0.00 0.00 0.00
Valid Dates: 06/29/2009 to 06/29/2010 Pass Cancellation)
CANCELLATION
Pass Holder: Ethen Clark Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly AQ HH Addl (YAQHRADD), #73715 0.00 0.00 0.00 0.00 0.00
Valid Dates: 06/29/2009 to 06/29/2010 Pass Cancellation)
G /L_Code. Descri Ac count Number Cst Cntr Description Account Number Amoun
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 82.00 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.
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PASS REFUND RECEIPT
Receipt 350896
Payment Date: 11/04/2009
Household 1484
PREVIOUS NET HOUSEHOLD BALANCE 110.00
Processed on 11/04/09 11:51:56 by ABK FEES CHANGED ON CANCELLED ITEMS 220.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 28.00
NET AMOUNT.FROM'CANCELLED ITEMS 192.00
HH BALANCE APPLIED TO THIS RECEIPT 110.00
TOTAL'AMOUNT<REFUNDED 82.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 82.00 Made By REFUND FINAN With Reference Pass cancel error
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 rd refunds.
Authorize Siig atur 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.
Terms
Clark, Natalie
Date Due
728 Prairie Drive
Brownsburg, IN 46112
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
82.00
11/4/09 350896 Refund
Total 82.00
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
20_
Clerk- Treasurer
Voucher No. Warrant No.
Clark, Natalie Allowed 20
728 Prairie Drive
Brownsburg, IN 46112
In Sum of
82.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 350896 4358400 82.00 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
5 -Nov 2009
Signature
82.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund