215407 12/11/2012 CITY OF CARMEL, INDIANA VENDOR: 366753 Page 1 of 1
ONE CIVIC SQUARE KERRY RYAN
` ) CARMEL, INDIANA 46032 CHECK AMOUNT: $121.50
12425 SPRINGBROOKE RUN
CARMEL IN 46033 CHECK NUMBER: 215407
CHECK DATE: 12/11/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 121 . 50 PARKS DEPARTMENT REFU
GLOBAL REFUND RECEIPT
Receipt# 966501
Carmel @ lay Payment Date: 11/05/12
,j
ParksAccrcation Household #: 38713
RE
Woodbrook Elementary QE� 6 202 Kerry Ryan Hm Ph: (317)574-8079
4311 East 116th Street ; 12425 Springbrooke Run
Carmel IN 46033 12 Carmel IN 46033 Cell Ph:(317)506-0323
$y; - _� ryans @indy.rr.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Pass Details
CANCELLATION - Refund Of 121.50
Pass Holder: Emily Ryan Fees+Tax Discount Prev Paid Cur Paid Amount Due
Pass Type: 10-Visit(ESE1 OV), #135997 13.50 0.00 13.50 0.00 0.00
Valid Dates: 08/09/2011 to 05/24/2012 (Pass Cancellation)
Cancellation Effective: 11/05/2012
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 11/05/12 @ 12:45:18 by NUP FEES CHANGED ON CANCELLED ITEMS(+) 121.50-
NET AMOUNT FROM CANCELLED ITEMS
TOTAL AMOUNT AMOUNT REFUNDED 121.50
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 121.50 Made By=_>REFUND FINAN With Reference=_>Refund Check
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
Aut oriz ignature 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. _
1I N�
1 I
q00
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.
Ryan, Kerry Terms
12425 Springbrooke Run Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/5/12 966501 Refund $ 121.50
Total $ 121.50
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.
Ryan, Kerry Allowed 20
12425 Springbrooke Run
Carmel, IN 46033
In Sum of$
$ 121.50
ON ACCOUNT OF APPROPRIATION FOR
108 :ESE`
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-11 966501 4358400 $ 121.50 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
7-Dec 2012
I
Signature
$ 121.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund