170246 03/31/2009 w CITY OF CARMEL, INDIANA VENDOR: T362697 Page 1 of 1
D ONE CIVIC SQUARE REGINA WHITE CHECK AMOUNT: $40.00
CARMEL, INDIANA 46032
246 CRANSTON AVE
oH a CARMEL IN 46032 CHECK NUMBER: 170246
CHECK DATE: 3/3112009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NU MBER A DESCRIPTION
1047 4358400 236536 40.00 REFUNDS AWARDS.& TNDE
Via°
PASS REFUND RECEIPT
Receipt 236536
Payment Date: 03/09/2009
Household 15423
Home Phone: (317)690 -3565 MAR 5 2009
Work Phone: (317)
I
L
REGINA WHITE Monon Center
246 CRANSTON AVE Carmel IN 46032
j CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 20.00
Pass Holder: Regina White Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type. Yly FT Alt Res (YFTAR), #19692 0.00 0.00 0.00 0.00 0.00
Valid Dates: 01/18/2009 to 01/21/2010 Pass Cancellation)
Cancel Reason: did not realize pass would renew f j
CANCELLATION Refund Of 20.00
Pass Holder: Darren Herring Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Yly FT Alt Res (YFTAR), #19693 0.00 0.00 0.00 0.00 0.00
Valid Dates: 01/18/2009 to 01/21/2010 Pass Cancellation)
Cancel Reason: did not realize pass would renew
GIL Code Descrip Account Number Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 40.00. DR
The REVENUE account was DEBITED and the CONTROL account was CREDITED on the day of the refund.
Finance will have to DEBIT the CONTROL account for the amounts listed above after the checks have been written to the customers..
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 03/09/09 13:17:53 by SLR FEES CHANGED ON CANCELLED ITEMS 40.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET;' MOUNTyF,ROM.'CANCELLED:ITEM$ -w40 00
zTOTAL AMOUNT;REFUNDED ,�u §il•! e 40 fl0
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 40.00 Made By REFUND FINAN With Reference check
Page 1
PASS REFUND RECEIPT
Receipt 236536
Payment Date: 03/09/2009
Household 15423
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 Authorized Signature Date
q -y
�h
Page 2
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.
White, Regina Terms
246 Cranston Ave Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/9/09 236536 Refund 40.00
Total 40.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
White, Regina Allowed 20
246 Cranston Ave
Carmel, IN 46032
In Sum of$
40.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 236536 4358400 40.00 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
25 -Mar 2009
Signature
40.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund