169518 03/04/2009 CITY OF CARMEL, INDIANA VENDOR: 352597 Page 1 of 1
0 ONE CIVIC SQUARE MIKE LOUDEN CHECK AMOUNT: $348.00
CARMEL, INDIANA 46032 750 E 107TH ST
INDIANAPOLIS IN 46280 CHECK NUMBER: 169518
CHECK DATE: 314/2009
DEPARTMENT ACCOUNT PO NUMBER INVOI NUMBER AMOUNT DESCRIPTION:
1047 4358400 230981 348.0.0 REFUNDS AWARDS INDE
f
7 PASS REFUND RECEIPT
Receipt 230981-
Payment Date: 02/19/2009 7BY: 2 1 2009
Household 12394
Home Phone: (317)574 -9388
Work Phone: (317)289 -4975
F
w
MIKE LOUDEN Monon Center
750 E 107TH ST Carmel IN 46032
INDIANAPOLIS IN 46280
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Pass Details
CANCELLATION Refund Of 348.00
Pass Holder: Mike Louden Fees Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: Prm Yr HH R (PRMYRHHR), #14548 0.00 0.00 0.00 0.00 0.00
Valid Dates: 10/03/2008 to 10/03/2009 Pass Cancellation)
Cancel Reason: sytem error auto renewal
G/L Code Descri Accou _Numbe Csl Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 348.00 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 02/19/09 16:15:12 by CRB FEES CHANGED ON CANCELLED ITEMS 348.00
DISCOUNT APPLIED AGAINST CANCELLED FEES O 0 -00
SALES TAX CHARGED ON CANCELLED FEES 0,00
1. NET.AMOUNT,FROM CANCELLED11TEMS 348.00
TOTAL'AMOUNV REFUNDED 348.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 348.00 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 r Author ed Signature Date
Page 1
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
i
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.
Louden, Mike Terms
750 E 107th St Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2119109 230981 Refund 348.00
Total 348.00
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.
Louden, Mike Allowed 20
750 E 107th St
Indianapolis, IN 46280
In Sum of
J 348.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 230981 4358400 348.00 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
26 -Feb 2009
P&'Alm ms'
Signature
348.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund