169119 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: T362570 Page 1 of 1
ONE CIVIC SQUARE AUDREY PRATT CHECK AMOUNT: $54.52
CARMEL, INDIANA'46032 477 ARBOR DRIVE
'�y_oN `off CARMEL IN 46032 CHECK NUMBER: 169119
CHECK DATE: 2/17/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DESCRIPTION
1047 4358400 221032 54.52 REFUNDS AWARDS INDE
I
I
PASS REFUND RECEIPT
Receipt 221032
Payment Date: 01/20/2009
Household 4224
Home Phone: (317)402 -9487
Work Phone: (317)208 -3644
AUDREY PRATT Monon Center
477 ARBOR DRIVE Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 54.52
Pass Holder: Audrey Pratt Fees +Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly FT Alt Res (YFTAR), #24754 165.48 0.00 165.48 0.00 0.00
Valid Dates: 05/13/2008 to 04/13/2009 Pass Cancellation)
Fee Details: Fee Description Amoun t Count Discount Sales Tax Total Fee
Yearly Fitness Adult 165.48 1.00 0.00 0.00 165.48
Cancel Reason: No time and issues.
GIL Code Description Account Number Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 54.52 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 t
Processed on 01(20109 14:17:55 by CRB FEES CHANGED ON CANCELLED ITEMS 54.52
DISCOUNT APPLIED AGAINST CANCELLED FEES O 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NETAMOUNT�F ,ROM,CANCEL 54:52
TOTi4Ls- AMOUNT *REF.UNDED" ,a 54:52',;
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 54.52 Made By REFUND FINAN With Reference ref fin
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.
Authorized Signature Date Authorized Signature Date
Page 1
J 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.
Pratt, Audrey Terms
477 Arbor Drive Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/20/09 221032 Refund 54.52
Total 54.52
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.
Pratt, Audrey Allowed 20
a 477 Arbor Drive
Carmel, IN 46032
In Sum of
54.52
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITILE AMOUNT Board Members
Dept
1047 221032 4358400 54.52 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
13 -Feb 2009
Signature
54.52 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund