HomeMy WebLinkAbout233509 06/11/14 a u,C�q�R`
CITY OF CARMEL, INDIANA VENDOR: 368274
i ONE CIVIC SQUARE ALEJANDRO ILIZALITURRI CHECK AMOUNT: $ ......98.00'
CARMEL, INDIANA 46032 99 2ND AVE SW,APT 3D CHECK NUMBER: 233509
°+,,;,oN�.= CARMEL IN 46032 CHECK DATE: 06/11/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 1265139 98.00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 1265139
r'r l o ip Payment Date: 06/04/14
r sAccre-anon Household #: 58781
'1DJ
Monon Community Center ' JUN - 6 2014 i Alejandro Ilizaliturri Hm Ph: (813)812-8898
Carmel IN 46032 99 2nd Av SW
f7: ,. 34
Apt 3d - Cell Ph:
`77f Carmel IN 46032
Phone: (317)848-7275 laurdes_pinedac@hotmail.com
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION - Refund Of 52.00
Enrollee Name: Sophia Illzaliturri Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 143013-11 Learn to Swim Level 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 05/05/2014 (Cancelled)
Class'Location: Outdoor Lap Pool 5 Class Dates: 06/09/2014 to 06/12/2014
Monon Community Cntr 9:OOA to 9:55A
M,Tu,W,Th
Carmel, IN 46032 Scheduled Sessions: 4
(317)848-7275
Cancel Reason: Advanced Notice
CANCELLATION - Refund Of 46.00
Enrollee Name: Andros Illzaliturri Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 143009-27 Preschool Level 1 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 05/02/2014 (Cancelled)
Class Location: Outdoor Lap Pool 1 Class Dates: 06/09/2014 to 06/12/2014
Monon Community Cntr 10:OOA to 10:45A
M,Tu,W,Th
Carmel, IN 46032 Scheduled Sessions: 4
(317)848-7275
Cancel Reason: Advanced Notice
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 06/04/14 @ 10:31:58 by KTOURNEY FEES CHANGED ON CANCELLED ITEMS(+) 105.00-
SURCHARGE APPLIED AGAINST CANCELLED FEES(-) 7.00-
NET AMOUNT FROM CANCELLED ITEMS 98.00-
TOTAL AMOUNT REFUNDED 98.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 98.00 Made By=_>REFUND FINAN With Reference==>
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issued.
Ldl 4
Authorized Signatl{ Date Authorized Signature Date
Page# 1 of 2
� o� 50 . as SW
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.
Ilizaliturri, Alejandro Terms
99 2nd Av SW, Apt 3D Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/4/14 1265139 Refund $ 98.00
Total $ 98.00
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.
Ilizaliturri, Alejandro Allowed 20
99 2nd Av SW, Apt 3D
Carmel, IN 46032
In Sum of$
$ 98.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#or INVOICE NO. ACCT#/TlTLE AMOUNT Board Members
Dept#
1096-10 1265139 4358400 $ 98.00 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
9-Jun 2014
Signature
$ 98.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund