179235 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 363551 Page 1 of 1
ONE CIVIC SQUARE AMANDA HAMMOND CHECK AMOUNT: $10.00
,f CARMEL, INDIANA 46032 611 EMERSON ROAD
CARMEL IN 46032 CHECK NUMBER: 179235
CHECK DATE: 11/11/2009
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 348245 10.00 REFUNDS AWARDS INDE
PASS REFUND RECEIPT
Receipt 348245
Payment Date: 10/23/09
Household 12849
Monon Center a°9 Amanda Hammond Hm Ph: (317)753 -7017
Carmel IN 46032 611 Emerson Rd Wk Ph: (317)
OCT 2009 Carmel IN 46032 Cell Ph: (317)753-7017
amandah @adoptionsupportcenter.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Ong Bal Refund New Bal
Module: Pass Management 10.00- 10.00 0.00
G/L Code Description Number__ Cst Cntr Description Account Number
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 10.00 DR
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 10.00
Processed on 10/23/09 c@ 12:43:26 by LVA NEW REFUND AMOUNT 10.00
TOTAL REFUNDABLE AMOUNT 10.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 10.00 Made By REFUND FINAN With Reference transfer passes
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issu No cash or credit card refunds. A
o a�l
Authorized Si ature Da a Authorized Signature Date
T1'QV +O NI C QI Ve_ Q)-s5
Lf x(00 �-C (0 ��00
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.
Hammond, Amanda Terms
611 Emerson Rd Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/23/09 348245 Refund 10.00
Total 10.00
I 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.
V Hammond, Amanda Allowed 20
611 Emerson Rd
Carmel, IN 46032
In Sum of
10.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 348245 4358400 10.00 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
5 -Nov 2009
Signature
Is 10.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund