179741 11/24/2009 CITY OF CARMEL, INDIANA VENDOR: 363599 Page 1 of 1
ONE CIVIC SQUARE DAVID KNAUSS
CARMEL, INDIANA 46032 PO BOX 876 CHECK AMOUNT: $189.36
CARMEL IN 46082
CHECK NUMBER: 179741
CHECK DATE: 11/24/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE N AMOUNT DESCRIPTION
1047 4358400 355823 189.36 REFUNDS AWARDS INDE
`r
PASS REFUND RECEIPT
Receipt 355823
Payment Date: 11/17/09
Household 30423
Monon Center David Knauss Hm Ph: (317)815 -1222
Carmel IN 46032 P. O. Box 876
Carmel IN 46082 Cell Ph:
dknauss @indy.rr.com
Ph:.me: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 189.36
Pass Holder: David Knauss Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly FT Adult (YFTAR), #80422 50.64 0.00 50.64 0.00 0.00
Valid Dates: 09/01/2009 to 09/01/2010 Pass Cancellation)
Cancel Reason: unhappy with fitness center
G/L 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 189.36 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
Processed on 11/17/09 11:12:06 by MAK FEES CHANGED ON CANCELLED ITEMS 189.36
:NET 'AMOUNT FROM;CANCELLED ITEMS 189.36-;=
30TAL AMOUNT REFUNDED
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 189.36 Made By REFUND FINAN With Reference
All refunds are subject to S to and of ounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. No c edit rd funds.
n
u onzed Signature Date Authorized Signature Date
I
NOV 1 9 2009
UY
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.
Knauss, David Terms
P.O. Box 876 Date Due
Carmel, IN 46082
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/17/09 355823 Refund 189.36
Total 189.36
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.
Knauss, David Allowed 20
P.O. Box 876
Carmel, IN 46082
In Sum of
189.36
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 355823 4358400 189.36 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 -Nov 2009
Signature
189.36 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund