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Home My WebLink About167610 01/07/2009 CITY OF CARMEL, INDIANA VENDOR: T362340 Page 1 of 1 b ONE CIVIC SQUARE MONICA DRAGON CHECK AMOUNT: $40.00 JJ CARMEL, INDIANA 46032 4636 FOSTER DRIVE CARMEL IN 46033 CHECK NUMBER: 167610 CHECK DATE: 1/7/2009 DEPARTMENT ACCOUNT PO NUM BER IN VOICE NUM A DESCR IPTION 1047 4355400 40.00 REFUNDS AWARDS INDE IK PASS REFUND RECEIPT Receipt 206006 DEC 1 9 2008 Payment Date: 12/02/2008 Household 8010 BY Home Phone: (317)569 -1664 Work Phone: (317)888 -2829 MONICA DRAGON Monon Center 4636 FOSTER DRIVE Carmel IN 46032 CARMEL IN 46033 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Pass Details CANCELLATION Pass Holder: WIII Dragon Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Yly FT Alt Res (YFTAR), #13075 0.00 0.00 20.00- 20.00 0.00 Valid Dates: 10/03/2008 to 10103/2009 Pass Cancellation) Cancel Reason: Computer Error in renewal MEMBERSHIP CHANGE Refund Of 40.00 Pass Holder: Will Dragon Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Vu AQ Alt Res 10 (VAQAR10), #7863 0.00 0.00 0.00 0.00 0.00 Valid Dates: 06/10/2007 to 12/31/2099 Pass Change) Fee Details: Fee Description Amo unt Co unt Discount Sales Tax Total Fee Value Aquatics Adult 0.00 1.00 0.00 0.00 0.00 G/L Code Description Account Number Cst Cntr Descri Account Number Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 40.00 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 20.00 Processed on 12/02/08 09:45:41 by EMB FEES CHANGED ON CANCELLED ITEMS 20.00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 NETAMOUNT .F,ROMECANCELLEDi1TE1NS'r li 2D1'00' FEES ADJUSTED ON CHANGED ITEMS 40.00 DISCOUNT APPLIED AGAINST THESE FEES 0.00 SALES TAX CHARGED ON CHANGED FEES 0.00 NETS 1MOUNT= _';F-ROM';CHANGEd= 1TEMS.� r ;4D:'OOm HH BALANCE APPLIED TO THIS RECEIPT( 20.00 Page 4 1 PASS REFUND RECEIPT Receipt 206006 Payment Date: 12/02/2008 Household 8010 TOTAL=AMOUNTREFUNDEDT' X4 NEW NET HOUSEHOLD BALANCE 0.00 Refund of 40.00 Made By REFUND FINAN With Reference Payment of 20.00 Made By Pass Management Credit Balance 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 ignature Date Authorized Signature Date Page 2 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. Dragon, Monica Terms 4636 Foster Drive Date Due Carmel, IN 46033 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 1212108 206006 Refund 40.00 Total 40.00 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. Dragon, Monica Allowed 20 4636 Foster Drive Carmel, IN 46033 In Sum of 40.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 206006 4358400 40.00 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 Signature 40.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund