HomeMy WebLinkAbout167793 01/20/2009 CITY OF CARMEL, INDIANA VENDOR: T362367 Page 1 of 1
ONE CIVIC SQUARE ELIZABETH SELM
CARMEL,. INDIANA 46032 20 SPRING DR CHECK AMOUNT: $45.00
ZIONSVILLE IN 46077 CHECK NUMBER: 167793
CHECK DATE: 1/2012009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOU DESCRIPTION
1047 4358400 215069 45.00 REFUNDS AWARDS INDE
A
ACTIVITY REFUND RECEIPT
Receipt 215069
Payment Date: 01/05/2009 JAN �i 2009
Household 22723
Home Phone: (317)733 -6360
Work Phone:
ELIZABETH SELM Monon Center
20 SPRING DR Carmel IN 46032
ZIONSVILLE IN 46077
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Module: Activity Registration Oria Bel Refund New Bal 45.00- 45.00 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 45.00 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 HOUSEHOLD BALANCE 45.00
Processed on 01/05/09 09:05:29 by TCP NEW REFUND AMOUNT 45.00
TOTAL REFUNDA13LE AMOUNT
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 45.00 Made By REFUND FINAN With Reference Low Enrollment
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.
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Authorized Signature Date Authorized Signature Date
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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.
Selm, Elizabeth Terms
20 Spring Dr Date Due
Zionsville, IN 46077
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
115109 215069 Refund 45.00
Total 45.00
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.
Seim, Elizabeth Allowed 20
20 Spring Dr
Zionsville, IN 46077
In Sum of
45.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #[TITLE AMOUNT Board Members
Dept
1047 215069 435840a 45.00 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
15 -Jan 2009
Signature
45.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund