175196 07/22/2009 a CITY OF CARMEL, INDIANA VENDOR: 363078 Page 1 of 1
ONE CIVIC SQUARE NICK URANKAR
0 CHECK AMOUNT: $233.16
s,�ra CARMEL, INDIANA 46032 51111 STEAMWOOD DRIVE
GRANGER IN 46530 CHECK NUMBER: 175196
CHECK DATE: 7/22/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 233.16 PARKS DEPARTMENT REFU
r"
PASS REFUND RECEIPT
Receipt 284622
Payment Date: 06124/2009
Household 22787
Home Phone: (574 )855 -7362
Work Phone:
NICK URANKAR Monon Center JUL 1 0 1009
51111 STREAMWOOD OR Carmel IN 46032
GRANGER IN 46530
Phone: (317 )848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 116.58
Pass Holder: Nick Urankar Fees Tax isc .Qunt Prev Paid Cur Paid Amount Due
Pass Type: Prm Yr Adult R (PRMYRADR), #42630 263.42 0.00 263.42 0.00 0.00
Valid Dates: 10/1412008 to 10/14/2009 Pass Cancellation)
Fee Details: Fee Description _.Amount Count, Discount Sales Tax T ota €_Fee„
Prem. Yearly Adult R 263.42 1.00 0,00 0.00 263.42
CANCELLATION Refund Of 116.58
Pass Holder: Chelssie Urankar Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prm Yr Adult R (PRMYRADR), #42631 263.42 0.00 263.42 0.00 0.00
Valid Dates: 1011412008 to 10/14/2009 Pass Cancellation)
Fee Details: Fee Description,_._ Amount Count Discount_ Sales Tax _Total Fee.
Prem. Yearly Adult R 263.42 1.00 0.00 0.00 263.42
GfL,Gode Description. Account Number_ CstCntr Description,"," Account Number—. Amount
999999 Control Account (AP) Enter Control Accl CNTRL Control Account (AP) Enter Control Acct here 233.16 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 06124/09 11:44:13 by MAK FEES CHANGED ON CANCELLED ITEMS 233.16
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 233:16-
TOTAL AMOUNT REFUNDED 233.16
NEW NET HOUSEHOLD BALANCE 0.00
11
III®
Page 1
PASS REFUND RECEIPT
Receipt 284622
Payment Date: 06/24/2009
Household 22787
Refund of 233.16 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 ca h or credit card refunds.
.�rk- 7, L�?
thorized Signature Date Authorized Signature Date
Page 2
ACCOUNTS PAYABLE VOUCHER
L 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.
Terms
Urankar, Nick
Date Due
51111 Streamwood Dr
Granger, IN 46530
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
233.16
612 4/09 284622 Refund
Total E$233.16
s), or bill(s) is (are) true and correct and I have audited same in accordance
I hereby certify that the attached invoice(
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer
Voucher No. Warrant No.
Urankar, Nick Allowed 20
51111 Streamwood Dr
Granger, IN 46530
In Sum of
233.16
ON ACCOUNT OF APPROPRIATION FOR
104 Program „Fund
PO# or INVOICE NO. ACCT #1TITL AMOUNT Board Members
Dept
1047 284622 4358400 233.16 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
16 -Jul 2009
Signature
233.16 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund