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170245 03/31/2009 CITY OF CARMEL, INDIANA VENDOR: 353745 Page 1 of 1 4` ONE CIVIC SQUARE JEANIE STONE CARMEL, INDIANA 46032 12691 HONORS DRIVE CHECK AMOUNT: $458.00 CARMEL IN 46033 CHECK NUMBER: 170245 CHECK DATE: 3/31/2009 DEPARTMENT AC PO NUMBER INVOI NUMBER AMOUNT DESCRIPT 1046 4358400 232921 458.00 REFUNDS AWARDS INDE PASS REFUND RECEIPT Receipt 232921 Payment Date: 02/26/2009 Household 2942 ,Home Phone: (317)844 -2892 L11AR 4 8 2009 Work Phone: (317)651 -7304 JEANIE STONE Prairie Trace Elemen 12691 HONORS DR. 14200 North River Road CARMEL IN 46033 Carmel IN 46033 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Pass Details CANCELLATION Refund Of 229.00 Pass Holder: Owen Stone Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Mar Month PM (ESEMMP), #58227 0.00 0.00 0.00 0.00 0.00 Valid Dates: 03/02/2009 to 04/02/2009 Pass Cancellation) Cancel Reason: will not be attending in March CANCELLATION Refund Of 229.00 Pass Holder: TriSten Stone Fees Tax Discount Prev Paid Cur Paid Amount Due Pass Type: Mar Month PM (ESEMMP), #58228 0.00 0.00 0.00 0.00 0.00 Valid Dates: 03/02/2009 to 04/02/2009 Pass Cancellation) Cancel Reason: will not be attending in March 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 458.00 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 02126/09 12:43:21 by SLS FEES CHANGED ON CANCELLED ITEMS 458.00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 NET AMOUNT FROM CANCELLED ITEMS 458.00 TOTAL AMOUNT REFUNDED, 458.00 NEW NET HOUSEHOLD BALANCE 0.00 Refund of 458.00 Made By REFUND FINAN With Reference Page 1 PASS REFUND RECEIPT Receipt 232921 Payment Date: 02/26/2009 Household 2942 All refunds re subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be issued. N cash or credit card refunds. A thori d Signature Date Authorized Signature Date '7 -I Page 2 ACCOUNTS PAYABLE VOUCHER w 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. Stone, Jeanie Terms a 12691 Honors Dr Date Due Carmel, IN 46033 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 2/26/09 232921 Refund 458.00 Total 458.00 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 ,20 Clerk- Treasurer Voucher No. Warrant No. Stone, Jeanie Allowed 20 12.691 Honors Dr Carmel, IN 46033 In Sum of 458.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1046 232921 4358400 458.00 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 458.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund