170344 03/31/2009 CITY OF CARMEL, INDIANA VENDOR: T362693 Page 1 of 1
1 ONE CIVIC SQUARE DAVID NGUYEN CHECK AMOUNT: $165.70
4+ CARMEL, INDIANA 46032 13866 FERNLEAF WAY
CARMEL IN 46033 CHECK NUMBER: 170244
CHECK DATE: 3/31/2009
DEPARTMENT ACCOUN PO N UMBER INVOICE NUMBER AMOUNT DES CRIPTION
1047 4358400 240876 165.70 REFUNDS AWARDS INDE
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GLOBAL REFUND RECEIPT
Receipt 240876
Payment Date: 03/18/2009
Household 22137
Home Phone: (317)573 -9963
Work Phone: (317)585 -5785
MAR 2 5 2009
DAVID NGUYEN Monon Center
13866 FERNLEAF WAY Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 165.70- 165.70 0.00
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 165.70 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 CREDIT HOUSEHOLD BALANCE 165.70
Processed on 03/18/09 16:42:55 by SLR NEW REFUND AMOUNT 165.70
TOTAL REFUNDABLE AMOUNT-` 165:70:
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 165.70 Made By REFUND FINAN With Reference check
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 Signature Date Autho ized Signature Date
7 do -Zl v 0
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.
Nguyen, David Terms
13866 Fernleaf Way Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/18/09 240876 Refund 165.70
Total I 165.70
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
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Voucher No. Warrant No.
Nguyen, David Allowed 20
13866 Fernleaf Way
Carmel, IN 46033
In Sum of
c,
165.70,
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1047 240876 4358400 165.70 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
25 -Mar 2009
Signature
165.70 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund