171980 04/29/2009 a „tif CITY OF CARMEL, INDIANA VENDOR: 362479 Page 1 of 1
0 `z ONE CIVIC SQUARE NADINE PENMAN
CARMEL, INDIANA 46032 5103 ST CHARLES PLACE CHECK AMOUNT: $25.00
CARMEL IN 46033 CHECK NUMBER: 171980
CHECK DATE: 4/29/2009
P ,EPARTMENT ACCOU PO NUMBER IN AMO UNT DE SCRIPTI ON
y 1047 4358400 185828 25.00 REFUNDS AWARDS INDE
-t
PASS REFUND RECEIPT
fty
r
Receipt 185828
Payment Date: 09/05/2008
Hciusehold 11627 0 PEI ;1
Home Phone: (317)815 -8330
Work Phone: APR 16 1009
BY:
NADINE PENMAN Monon Center
5103 ST. CHARLES PLACE Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 25.00
Pass Holder: Nadine Penman Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Vu AQ Yth Res10 (VAQYR10), #23060 0.00 0.00 0.00 0.00 0.00
Valid Dates: 04/0812008 to 12/31/2099 Pass Cancellation)
Pass Visit Info: Number of Visits: 10
Cancel Reason: N/A
G/L de Description_.__ Account Number Cst Cntr Description__ Account Number .....Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 25.00 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 09/05/08 11:35:59 by EMS FEES CHANGED ON CANCELLED ITEMS 25.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 25.0
TOTAL AMOUNT REFUNDED 25.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 25.00 Made By REFUND FINAN With Reference
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process0 il l be
issued. cash or credit card refunds.
Authorized Signature Date Authorized Signature Date
7--7 -1 57D7
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.
Penman, Nadine Terms
5103 St. Charles Place Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/5/08 185828 Refund 25.00
Total 25.00
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
Y -a
Voucher No. Warrant No.
Penman, Nadine Allowed 20
5103 St. Charles Place
Carmel, IN 46033
In Sum of
t
25.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 185828 4358400 25.00 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
22 -Apr 2009
Signature
25.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund