205524 01/17/2012 CITY OF CARMEL, INDIANA VENDOR: 365951 Page 1 of 1
ONE CIVIC SQUARE CHANDRA KRISHNAMANENI
CARMEL, INDIANA 46032 14420 CHARIOTS WHISPER DRIVE CHECK AMOUNT: $212.00
WESTFIELD IN 46074
<.o CHECK NUMBER: 205524
CHECK DATE: 1/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 769521 212.00 PARKS DEPARTMENT REFU
PASS REFUND RECEIPT
Clay Receipt 769521
Payment Date: 01/06/12
Nirks&Recreation Household 4300
Monon Community Center Chandra Krishnamaneni Hm Ph: (317)574 -0122
Carmel IN 46032 14420 Chariots Whisper Dr. Wk Ph: (317)433 -3734
Westfield IN 46074 Cell Ph: (317)459 -7443
Phone: (317)848 -7275
rukkurao @yahoo.com
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 60.00
Pass Holder: Manish Krishnamaneni Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Drop -In Visit (ESEDROP), #88363 0.00 0.00 0.00 0.00 0.00
Valid Dates: 08/09/2011 to 05/24/2012 (Pass Cancellation)
Pass Visit Info: Num 3
Cancel Reaso do not need ese
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 152.00
Processed on 01/06/12 09:07:39 by BJJ FEES CHANGED ON CANCELLED ITEMS 60.00-
0 j� Y NET AMOUNT FROM CANCELLED ITEMS :60.00`
J AN O 9 2012 HH BALANCE APPLIED TO THIS RECEIPT 152.00-
TOTAL AMOUNT.REFUNDED '212:00
BY: NEW NET HOUSEHOLD BALANCE
0.00
Refund of 212.00 Made By REFUND FINAN With Reference
All refu s are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. o cash or credit card refunds.
-&41
A orized Signature Date Authorized Signature Date
Volunteer with Us!
Volunteers are the foundation of Carmel Clay Parks Recreation and we need your help! We are currently seeking volunteers
for special events, adaptive programs, parks and greenways, and Extended School Enrichment. If interested, please call Dana
at 317.843.3868 or register online at https:H2011 cpry .theregistrationsystem.com /en /1033!
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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.
Krishnamaneni, Chandra Terms
14420 Chariots Whisper Dr. Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) Amount
212.00
116112 769521 Refund
Total 212.00
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
1
Voucher No. Warrant No.
Krishnamaneni, Chandra Allowed 20
14420 Chariots Whisper Dr.
Westfield, IN 46074
In Sum of
212.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1081 -08 769521 4358400 212.00 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
12 -Jan 2012
&kb I aQj
Signature
212.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund