HomeMy WebLinkAbout234436 07/01/14 d.5�q
CITY OF CARMEL, INDIANA VENDOR: 368362
® �l ONE CIVIC SQUARE DEBORAH ZACHMAN CHECK AMOUNT: $*********6.00*
s. =a CARMEL, INDIANA 46032 1295 E 106TH ST CHECK NUMBER: 234436
+.$,ETON, INDIANAPOLIS IN 46280 CHECK DATE: 07101/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 6.00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 1286515
Carmel * Clay Payment Date: 06/23/14
Clay rks&Re creation Household#: 4445
Monon Community Center Deborah Zachman Hm Ph: (317)574-1444
Carmel IN 46032 1295 E. 106th Street
Indianapolis IN 46280 Cell Ph:(260)413-3895
Phone: (317)848-7275 debbiezachman@sbcglobal.net
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION -Refund Of 6.00
Enrollee Name: Andrew Zachman Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 148004-05 Adaptive Flowrider 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 04/02/2014 (Cancelled)
Class Location: Flowrider Class Dates: 07/01/2014 to 07/01/2014
MC Outdoor Aquatics 7:OOP to 8:30P
Tu
Carmel, IN 46032 Scheduled Sessions: 1
Cancel Reason: Conflicting event
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 06/23/14 @ 15:32:01 by MYADON FEES CHANGED ON CANCELLED ITEMS(+) 6.00-
NET AMOUNT FROM CANCELLED ITEMS 6.00-
TOTAL AMOUNT REFUNDED
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 6.00 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.
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Authorized Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
70 `--?
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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.
Zachman, Deborah Terms
1295 E 106th Street Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/23/14 1286515 Refund $ 6.00
Total $ 6.00
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
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Voucher No. Warrant No.
Zachman, Deborah Allowed 20
1295 E 106th Street
Indianapolis, IN 46280
n Sum of$
$ 6.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC !,
PO#or INVOICE NO. ACCT#/TlTLE AMOUNT Board Members
Dept#
1096-70 1286515 4358400 $ 6.00 41 hereby certify that the attached invoice(s), or
bills)is(are)true and correct and that the
'materials or services itemized thereon for
which charge is made were ordered and
(Ireceived except
f_
1.
i.
26-Jun 2014
Signature
$ 6.00 ' Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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