214994 12/04/2012 CITY OF CARMEL, INDIANA VENDOR: 366741 Page 1 of 1
ONE CIVIC SQUARE CATH DAHLE CHECK AMOUNT: $252.00
CARMEL, INDIANA 46032 11934 MANNINGS PASS
CARMEL IN 46032 CHECK NUMBER: 214994
CHECK DATE: 12/4/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 973813 252 . 00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 973813
Carmel Clay Payment Date: 12
Household #: 40744 0744
P rks& e creattorl
R_CE VED
Monon Community Center NOV 2 x012 Cath Dahle Hm Ph: (206)550-7139
Carmel IN 46032 309 Parkview Place Wk Ph: (317)988-3381
11934 Mannings Pass after nov Cell Ph:
BY: Carmel IN 46032
Phone: (317)848-7275 — -- c.dahle @yahoo.com
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 252.00- 252.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 252.00
Processed on 11/21/12 @ 13:34:42 by BJJ NEW REFUND AMOUNT(-) 252.00
TOTAL REFUNDABLE AMOUNT ' M ;,. 252:00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 252.00 Made By==>REFUND FINAN With Referenc -_> 1081-10-4358400
All refunds are subject to State Board of Accounts procedure a e840-6 weeks to process. No cash refunds will be
issue .
Au ,zed Signature Date Authorized Signature Date
Spend a relaxing evening taking a walk through the winter wonderland at Central Park on Saturday, December 1, from 6-9pm.
Enjoy carolers and hot chocolate as you take in the ambiance of more than 1,000 luminaries lighting the path through the
wetlands, floating over the lagoon, and spanning across the boardwalk. A beautiful sight of the 161-acre park is sure to be a
memory for you and your family. Free to the public. Register at carmelclayparks.com.
Escape Day Passes are non-refundable.
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2 Page# 1 of 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.
Terms
Dahle, Cath
Date Due
11934 Mannings Pass
Carmel, IN 46032
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
$ 252.00
11/21/12 973813 Change in status
T,otal $ 252.00
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.
Dahle, Cath Allowed 20
11934 Mannings Pass
Carmel, IN 46032
In Sum of$
$ 252.00
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-10 973813 4358400 $ 252.00 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
29-Nov 2012
C:Y�yI fi O/YYtI'Y)lhJ
Signature
$ 252.00 Accounts Payable Coordinator
Cost distribution ledger classification if _ Title
claim paid motor vehicle highway fund