167792 01/20/2009 CITY OF CARMEL, INDIANA VENDOR: T362366 Page 1 of 1
ONE CIVIC SQUARE ABBY RYAN
CARMEL, INDIANA 46032 734 W MAIN ST CHECK AMOUNT: $73.63
CARMEL IN 46032
CHECK NUMBER: 167792
CHECK DATE: 1/20/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 211052 73.63 REFUNDS AWARDS INDE
1 PASS REFUND RECEIPT
V
Receipt 211052
Payment Date: 12/18/2008
Household 4246 JAN 7 2009
Home Phone: (317)418 -2163 I
Work Phone: (317)208 -3673 I
ABBY RYAN Monon Center
734 W MAIN ST Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 73.63
Pass Holder: Abby Ryan Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly FT Alt Res (YFTAR), #23096 166.37 0.00 166.37 0.00 0.00
Valid Dates: 04/09/2008 to 04/09/2009 Pass Cancellation)
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Yearly Fitness Adult 166.37 1.00 0.00 0.00 166.37
Cancel Reason: Bedrest/Pregnancy
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 73.63 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 12/18/08 13:20:02 by RDG FEES CHANGED ON CANCELLED ITEMS 73.63
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET 'AMOUN T :FROM CANCELLED %ITEir S
TOTALir'AMOUNT REFUNDED .73.63'
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 73.63 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
issued. No cash or credit card refunds.
t P1181C8 Z425
Authorized Signature Date Authorized Signature Date
3
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.
Ryan, Abby Terms
734 W Main Street Date Due
Carmel, In 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/18/08 211052 Refund 73.63
r
Total 73.63
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.
Ryan, Abby Allowed 20
734 W Main Street
Carmel, In 46032
In Sum of
73.63
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 211052 4358400 73.63 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
15 -Jan 2009
Signature
73.63 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund