HomeMy WebLinkAbout169120 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: T362571 Page 1 of 1
0 ONE CIVIC SQUARE STACI PRATT
CARMEL, INDIANA 46032 220 RED OAK RIDGE CHECK AMOUNT: $174.00
CARMEL IN 46033
CHECK NUMBER: 169120
CHECK DATE: 211712009
DEPARTMENT ACCOUN PO NU MBE R I NVOICE NUMBE AMOUNT DESCRIPTION
1047 4358400 222826 174.00 REFUNDS AWARDS INDE
PASS REFUND RECEIPT
Receipt 222826'd RECEIVED
Payment Date: 01/28/2009
Household 1649 FEB 0 9 2009
Home Phone: (317)846 -8504
Work Phone: (317)842 -4247
BY:
STACI PRATT Monon Center
220 RED OAK RIDGE Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 174.00
Pass Holder: Mike Pratt Fees +Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prm Yr HH R (PRMYRHHR), #13900 0.00 0.00 0.00 0.00 0.00
Valid Dates: 10/03/2008 to 10/03/2009 Pass Cancellation)
Cancel Reason: card renewing error dec /jan withdrawls. SLR
CANCELLATION
Pass Holder: Stacl Pratt Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type. Prm Yr HH Add R (PRMHHADR), #13901 0.00 0.00 0.00 0.00 0.00
Valid Dates: 08/30/2007 to 08/30/2008 Pass Cancellation)
Cancel Reason: card renewing error dec /jan withdrawls. SLR
CANCELLATION
Pass Holder: Ryan Pratt Fees Tax Disc QUnt Prev Paid Cur Paid Amount Due
Pass Type: Prm Yr HH Add R (PRMHHADR), #13902 0.00 0.00 0.00 0.00 0.00
Valid Dates: 08/30/2007 to 08/30/2008 Pass Cancellation)
Cancel Reason: card renewing error dec /jan withdrawls. SLR
CANCELLATION
Pass Holder: Luke Pratt Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prm Yr HH Add R (PRMHHADR), #13903 0.00 0.00 0.00 0.00 0.00
Valid Dates: 08/30/2007 to 08/30/2008 Pass Cancellation)
Cancel Reason: card renewing error dec /jan withdrawls. SLR
Page 1
1 PASS REFUND RECEIPT
Receipt 222826
Payment Date: 01/28/2009
Household 1649
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 174.00 DR
e 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 01/28/09 10:23:07 by SLR FEES CHANGED ON CANCELLED ITEMS 174.00
DISCOUNT APPLIED AGAINST CANCELLED FEES O 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET'iAMOUNT'F,ROMV CANCELLEDITEMS'.;, z z ;1.74:00
TOTAL!AMOUNT;REFUNDED
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 174.00 Made By REFUND FINAN With Reference check refund
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.
uthorized Signature Date ,"Authorized Signature D to
51 9,
Page 2
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be property 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, Staci Terms
220 Red Oak Ridge Date Due
Carmel, IN 46033
Invoice Invoice Description
Date 'Number (or note attached invoice(s) or bill(s)) Amount
1128/09 222826 Refund 174.00
Total 174.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Pratt, Staci Allowed 20
220 Red Oak Ridge
Carmel, IN 46033
In Sum of
174.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #1TITLE AMOUNT Board Members
Dept
1047 222826 4358400 174.00 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
13 -Feb 2009
Signature
174.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund