HomeMy WebLinkAbout235143 7 /22/2014 CITY OF CARMEL, INDIANA VENDOR: 368447
ONE CIVIC SQUARE SUSAN LAND CHECK AMOUNT: $********20.00*
CARMEL, INDIANA 46032 10836 LATONIA LANE CHECK NUMBER: 235143
INDIANAPOLIS IN 46280 CHECK DATE: 07/22/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 1304581 20.00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 1304581
Carmelo o Clog Payment Date: 07/15/14
rks"Aecreation Household M 40770
Monon Community Center - Susan Land' Hm Ph: (317)294-7751
Carmel IN 46032 ,J�II _� 201 ane
Indianapo10836 lis IINL46280 Cell Ph;
may; SuzieQ908@hotmail.com
Phone: (317)848-7275
Fed Tax ID#35-6000972 —_
Enrollment Details
CANCELLATION -Refund Of 10.00
Enrollee Name: Susan Land Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 147029-02 Unlocking Social Sec 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 06/02/2014 (Cancelled)
Primary Instructor: Joel Harris
Class Location: Multipurpose Room B Class Dates: 07/15/2014 to 07/15/2014
Monon Community Cntr 6:OOP to 7:30P
Tu
Carmel, IN 46032 Scheduled Sessions: 1
(317)848-7275
Cancel Reason: advanced request
CANCELLATION -Refund Of 10.00
Enrollee Name: Robert Land Fees+Tax Discount Prey Paid Cur Paid Amount Due
Activity Number: 147029-02 Unlocking Social Sec 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 06/02/2014 (Cancelled)
Primary Instructor: Joel Harris
Class Location: Multipurpose Room B Class Dates: 07/15/2014 to 07/15/2014
Monon Community Cntr 6:OOP to 7:30P
Tu
Carmel, IN 46032 Scheduled Sessions: 1
(317)848-7275
Cancel Reason: advanced request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/15/14 @ 09:07:56 by MML FEES CHANGED ON CANCELLED ITEMS(+) 20.00-
NET AMOUNT FROM CANCELLED ITEMS 20.00-
TOTAL AMOUNT REFUNDED 20.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 20.00 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
issued.
Page# 1 of 2
ACTIVITY REFUND RECEIPT
Car "Mel Receipt# 1304581
rksiaRecreation Payment Date: 07/15/2014
Household#: 40770
'711511 �s
Authorized Signature Date Authorized Signature Date
t6%•-56. 1�35MO
Escape Day Passes are non-refundable.
i
JUL IS 2014 I
Page# 2 of 2
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to beP roperly 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.
Land, Susan Terms
10836 Latonia Lane Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/15/14 1304581 Refund $ 20.00
i
Total Is 20.00
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
, 20
Clerk-Treasurer
i
Voucher No. Warrant No.
Land, Susan Allowed 20
10836 Latonia Lane
Indianapolis, IN 46280
,In Sum of$
i
$ 20.00 i
i I
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC '
I
PO#orBoard Members
INVOICE NO. ACCT#/TITLE AMOUNT '
Dept#
1096-50 1304581 4358400 $ 20.00 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
18-Jul 2014
Signature
$ 20.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund