227052 12/11/2013 CITY OF CARMEL, INDIANA VENDOR: 367791 Page 1 of 1
ONE CIVIC SQUARE REBECCA MUELLER CHECK AMOUNT: $182.00
CARMEL, INDIANA 46032 1232 HILLCREST DR
o� CARMEL IN 46033 CHECK NUMBER: 227052
CHECK DATE: 12111/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 182 . 00 REFUNDS AWARDS & INDE
GLOBAL REFUND RECEIPT
Receipt# 1178092
Ca",-e l * lay Payment Date: 12/04/13
J Household #: 42826
Parks Aecreation
Monon Community Center Rebecca Mueller Hm Ph: (317)908-8932
Carmel IN 46032 1232 Hillcrest Dr. Wk Ph: (317)472-3722
Carmel IN 46033 Cell Ph:(317)908-8932
rebeccamuell @earthlink.net
Phone: (317)848-7275
Fed Tax ID#35-6000972
Refund Details
Oria Bal Refund New Bal
Module: Pass Management 182.00- 182.00 0.00
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 182.00
Processed on 12/04/13 @ 15:28:47 by BJJ NEW REFUND AMOUNT(-) 182.00
TOTAL REFUNDABLE AMOUNT 182:00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 182.00 Made By==>REFUND FINAN With Reference=_>1081-5-4358400
C
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issue
& orized Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
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.
Mueller, Rebecca Terms
1232 Hillcrest Dr Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/4/13 1178092 - Refund $ 182.00
Total $ 182.00
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
120
Clerk-Treasurer
Voucher No. Warrant No.
Mueller, Rebecca Allowed 20
1232 Hillcrest Dr
Carmel, IN 46033
In Sum of$
$ 182.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-5 1178092 4358400 $ 182.00 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
6-Dec 2013
'p. �
signature
$ 182.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund