221845 07/11/2013 CITY OF CARMEL, INDIANA VENDOR: 367264 Page 1 of 1
ONE CIVIC SQUARE MOLLI SALTER
CARMEL, INDIANA 46032 3237 HAWTHORNE DR W CHECK AMOUNT: $195.00
o� CARMEL IN 46033 CHECK NUMBER: 221845
CHECK DATE: 7/11/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 195 . 00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1087008
a e l o0ay Payment Date: 07/01/13
FrCS& ecrea ion Household #: 47501
r
P,E C,FEJ!1 V��E]D�
Monon Community Center JUL 0 12013 Molll Salter Hm Ph: (317)596-1578
Carmel IN 46032 3237 Hawthorne Dr. W Wk Ph: (317) -
Cimel IN 46033 Cell Ph:(317)989-0621
BY: m(DIli4ll@hotmail.com
Phone: (317)848=7275
Fed Tax ID #35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 195.00- 195.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 195.00
Processed on 07/01/13 @ 09:27:13 by BJJ NEW REFUND AMOUNT(-) 195.00
TOTAL REFUNDABLE AMOUNT 195.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 195.00 Made By==>REFUND FINAN With Reference=_> 1081-2-4358400
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued. �4� 3
uthori ignature Date Authorized Signature Date
Escape Day Passes are non-refundable.
AXe
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
Salter, Molli
Date Due
3237 Hawthorne Dr. W
Carmel, IN 46033
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
$ 195.00
7/1/13 1087008 Refund
Total $ 195.00
I 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.
Salter, Molli Allowed 20
3237 Hawthorne Dr. W
Carmel, IN 46033
In Sum of$
$ 195.00
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE
PO#or Board Members
Dept#
INVOICE NO. ACCT#/TITLE AMOUNT
1081-2 1087008 4358400 $ 195.00 1 nereby 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
10-Jul 2013
I
Signature
$ 195.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund