171900 04/29/2009 CITY OF CARMEL, INDIANA VENDOR: 362803 Page 1 of 1
ONE CIVIC SQUARE SHARRI JACKSON CHECK AMOUNT: $15.00
t CARMEL, INDIANA 46032 10808 WESTON DRIVE
ray CARMEL IN 46032 CHECK NUMBER: 171900
CHECK DATE: 4/29/2009
DEPARTMENT ACCO PO NU INV OICE NUMBER AMO UNT DESCRIPTION
1046 4358400 250889 15..00 REFUNDS AWARDS INDE
1p
4
ACTIVITY REFUND RECEIPT
Receipt 250889 0 t it
Payment Date: 04/16/2009
Hcisehold 9401 A 1 6 2009
Home Phone: (314)873 -4648
Work Phone: (317)997 -9459
SHARRI JACKSON Monon Center
10808 WESTON DRIVE Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Orio Bal Refund New Bal
Module: Activity Registration 15.00- 15.00 0.00
G/L Code Descrip Account Numb C Cntr Description_ Accou N umber Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 15.00 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 15.00
Processed on 04/16/09 11:59:16 by JAS NEW REFUND AMOUNT 15.00
TOTAL REFUNDABLE AMOUNT 15.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 15.00 Made By REFUND FINAN With Reference
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issTd. o cash or credit card refunds.
A 0 0
tho a ignature Date Authorized Signature Date
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.
Jackson, Sharri Terms
10808 Weston Drive Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/16/09 250889 Refund 15.00
Total 15.00
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
20_
Clerk- Treasurer
9
Voucher No. Warrant No.
Jackson, Sharri Allowed 20
10808 Weston Drive
Carmel, IN 46032
In Sum of
15.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 250889 4358400 15.00 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
22 -Apr 2009
Signature
15.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund