221773 07/02/2013 CITY OF CARMEL, INDIANA VENDOR: 367244 Page 1 of 1
4�I ONE CIVIC SQUARE WENJUAN WU CHECK AMOUNT: $87.50
CARMEL, INDIANA 46032 5811 SEDGEGRASS
CARMEL IN 46032 CHECK NUMBER: 221773
CHECK DATE: 7/2/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 1075648 87 . 50 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1075648
Carmel e Clay Payment Date: 06/20/13
F arltsAccreation Household #: 11653
FBY:-Monon Community Center Wenjuan Wu Hm Ph: (317)
Carmel IN 46032 2 2013 Carmel IN 6032 Cell Ph:(832)231-5981
wendy5604 @yahoo.com
Phone: (317)848-7275
Fed Tax ID #35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Activity Registration 87.50- 87.50 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 87.50
Processed on 06/20/13 @ 13:19:55 by BJJ NEW REFUND AMOUNT(-) 87.50
TOTAL REFUNDABLE AMOUNT 87.50
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 87.50 Made By==>REFUND FINAN With Reference=_>1082-11-4358400 P C lufi) )
All refun are subject to State Board of Accounts procedures and may take 4-6 wee-s to process. No cash refunds will be
issued.
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)
Phor,1710Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
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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.
Wu, Wenjuan Terms
5811 Sedgegrass Date Due
Carmel, IN 46032
Invoice W Description
Date or note attached invoice(s) or bill(s)) Amount
$ 87.50
6120113 Refund
I
Total $ 87.50
1 hereby certify that the attached invoice(s),or biii(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.
Wu, Wenjuan Allowed 20
5811 Sedgegrass
Carmel, IN 46032
In Sum of$
$ 87.50
ON ACCOUNT OF APPROPRIATION FOR _
108 - ESE
PO#or Board Members
Dept#
INVOICE NO. ACCT#/TITLE AMOUNT
1082-11 1075648 4358400 $ 87.50 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
1-Jul 2013
Signature
$ 87.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund