HomeMy WebLinkAbout233374 06/04/14 ,��uS.4qq\ CITY OF CARMEL, INDIANA VENDOR: 366086
j; °' ONE CIVIC SQUARE DENNIS WHITAKER CHECK AMOUNT: $*******168.00*
?�, CARMEL, INDIANA 46032 5159 WARBLER WAY SOUTH CHECK NUMBER: 233374
M�TpN��` CARMEL IN 46033 CHECK DATE: 06/04/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 1258864 168.00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
arm- � l? Receipt# 1258864
� Payment Date: 05/29/14
Parks&fccreatioln Household#: 14901
Monon Community Center Dennis Whitaker Hm Ph: (317)566-8415
Carmel IN 46032 5159 Warbler Way S Wk Ph: (317)849-7900
Carmel IN 46033 Cell Ph:(317)440-1078
kwhitaker@indy.rr.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION -Refund Of 168.00
Enrollee Name: Madeline Whitaker Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 146206-02 Video Game Design 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 04/01/2014 (Cancelled)
Primary Instructor: Youth Tech
Class Location: Meeting Room Class Dates: 07/07/2014 to 07/10/2014
Monon Community Cntr 9:OOA to 12:OOP
M,Tu,W,Th
Carmel, IN 46032 Scheduled Sessions: 4
(317)848-7275
Cancel Reason: advanced request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 05/29/14 @ 06:30:35 by LVA FEES CHANGED ON CANCELLED ITEMS(+) 175.00-
SURCHARGE APPLIED AGAINST CANCELLED FEES(-) 7.00-
NET AMOUNT FROM CANCELLED ITEMS 168.00-
TOTAL AMOUNT REFUNDED 168.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 168.00 Made By=_>REFUND FINAN With Reference=_>advanced request
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
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Authorized Sign re Date Authorized Signature Date
Escape Day Passes are non-refundable.
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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.
Whitaker, Dennis Terms
5159 Warbler Way S Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/29/14 1258864 Refund $ 168.00
Total $ 168.00
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
120
Clerk-Treasurer
Voucher No. Warrant No.
Whitaker, Dennis Allowed 20
5159 Warbler Way S
Carmel, IN 46033
In Sum of$
$ 168.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-42 1258864 4358400 $ 168.00 �l 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
2-Jun 2014
i
Signature
$ 168.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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