HomeMy WebLinkAbout231901 4 /23/2014 CITY OF CARMEL, INDIANA VENDOR: 368137
ONE CIVIC SQUARE KOSAL TITH CHECK AMOUNT: $ '""`52.00'
CARMEL, INDIANA 46032 1340 WAYNE STREET#C CHECK NUMBER: 231901
,raN`o TROY OH 45373 CHECK DATE: 04/23/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 52.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt# 1235047
Carmel @lay Payment Date: 04/11/14
JJ Household #: 39378
ParksAccreatlon
Monon Community Center Kosal Tith Hm Ph: (937)241-0385
Carmel IN 46032 1340 Wayne Street#C
Troy OH 45373 Cell Ph:
babybear999@netzero.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION - Refund Of 52.00
Enrollee Name: Kosal Tith Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 347005-01 MCC Spring Open 2014 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 03/18/2014 (Cancelled)
Class Location: Gymnasium A Class Dates: 04/12/2014 to 04/12/2014
Monon Community Cntr 8:OOA to 8:OOP
Sa
Carmel, IN 46032 Scheduled Sessions: 1
(317)848-7275
Cancel Reason: low enrollment
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 04/11/14 @ 14:17:28 by MML FEES CHANGED ON CANCELLED ITEMS(+) 52.00-
NET AMOUNT FROM CANCELLED ITEMS 52.00-
TOTAL AMOUNT REFUNDED 52.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 52.00 Made By=_>REFUND FINAN With Reference=_>low enrollment
All refunds are bject t tate Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
'
A horized Sign ure at Aut rite gnature D e
ib�6 , 5o. 1 59"0o
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.
Tith, Kosal Terms
1340 Wayne Street# C Date Due
Troy, OH 45373
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/11/14 1235047 Refund $ 52.00
I
Total $ 52.00
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
I
Voucher No. Warrant No.
Tith, Kosal Allowed 20
1340 Wayne Street# C
Troy, OH 45373
in Sum of$
$ 52.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-50 1235047 4358400 $ 52.00 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
17-Apr 2014
Signature
$ 52.00 _ Accounts Payable Coordinator
Cost distribution ledger classification if Title
t claim paid motor vehicle highway fund