HomeMy WebLinkAbout167671 01/17/2009 CITY OF CARMEL, INDIANA VENDOR: T362344 Page 1 of 1
ONE CIVIC SQUARE ROCHELLE PAQUETTE
r, CARMEL, INDIANA 46032 10778 CENTRAL AVE CHECK AMOUNT: $64.00
INDIANAPOLIS IN 46280 CHECK NUMBER: 167671
CHECK DATE: 1/712009
DEPARTMENT ACCOUNT PO NUMB INVOI NU MBER AMOUNT DESCRIP
1047 4358400 207849 64.00 REFUNDS AWARDS INDE
r,
0
r PASS REFUND RECEIPT
Receipt 207849
Payment Date: 12/10/2008
Household 20004
Home Phone: (317)345 -9724 DE g
Work Phone:
ROCHELLE PAQUETTE Monon Center
10778 CENTRAL AVE Carmel IN 46032
INDIANAPOLIS IN 46280
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 64.00
Pass Holder: Rochelle Paquette Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prem. Yrly Ad R (PRMYRADR), #29659 96.00 0.00 96.00 0.00 0.00
Valid Dates: 07/01/2008 to 07/01/2009 Pass Cancellation)
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Prem. Yearly Adult R 96.00 1.00 0.00 0.00 96.00
Cancel Reason: Using employee pass.
G/L Code Descri Account Number Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 64.00 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 12/10/08 15:20:41 by EMB FEES CHANGED ON CANCELLED ITEMS 64.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
T.OTAL::AMOUNTREFUNDED.t
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 64.00 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.
1 tC7 fi'g I 5 O
Authorized Sig ature Date Authorized Signature Date
43 Iln'o
Page 1
Or ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind noffeservice, nits, price performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour,
Payee Purchase Order No.
Terms
Paquette, Rochelle Date Due
10778 Central Ave
Indianapolis, IN 46280
Invoice
Invoice Description Amount
Date Number (or note attached invoice(s) or bills 64.00
12110108 207849 Refund
Total 64.00
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.
Paquette, Rochelle Allowed 20
10778 Central Ave
Indianapolis, IN 46280
In Sum of
64.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 207849 4358400 64.00 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
19 -Dec 2008
7J
Signature
64.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund