HomeMy WebLinkAbout235624 08/06/14 (9,
CITY OF CARMEL, INDIANA VENDOR: 368514
ONE CIVIC SQUARE MISATO NAGATA CHECKAMOUNT: $********25.00*
CARMEL, INDIANA 46032 8804 ARBOR LAKE DR,APT 1216 CHECK NUMBER: 235624
INDIANAPOLIS IN 46268 CHECK DATE: 08/06/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 1315352 25.00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 1315352
Carmel • Cipy Payment Date: 07/24/14
Household#: 58249
Nrk�& ccreation
Monon Community Center Misato Nagata
Carmel IN 46032 8804 Arbor Lake Dr
Apt 1216 Cell Ph:(317)914-3909
Indianapolis IN 46268
Phone: (317)848-7275 mifasoo@yahoo.co.jp
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION -Refund Of 25.00
Enrollee Name: Atsuhiro Nagata Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 145104-04 Let's Look 4 Insects 7.00 0.00 0.00 7.00 0,00
.Enrollment Date: 07/01/2014- (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Meeting Room Class Dates: 08/05/2014 to 08/26/2014
Monon Community Cntr 10:OOA to 11:30A
Tu
Carmel, IN 46032 Scheduled Sessions: 4
(317)848-7275
Cancel Reason: advanced request to cancel
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/24/14 @ 12:52:56 by MJN FEES CHANGED ON CANCELLED ITEMS(+) 32.00-
SURCHARGE APPLIED AGAINST CANCELLED FEES(-) 7.00-
NET`AMOUNT FROM CANCELLED ITEMS `.25:00
TOTAL AMOUNT REFUNDED 25:00
NEW NET HOUSEHOLD BALANCE 0.00
,Refudd of=_> 25.00 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.
IyAt4l�40 7/ 21A
uthorized Signature Date Authorized Signature Date
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.
Nagata, Misato Terms
8804 Arbor Lake Dr, Apt 1216 Date Due
Indianapolis, .IN 46268
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/24/14 1315352 Refund $ 25.00
t
Total $ 25.00
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.
Nagata, Misato Allowed 20
8804 Arbor Lake Dr,Apt 1216
Indianapolis, IN 46268
In Sum of$
i
$ 25.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#or Board Members
Dept# INVOICE NO. ACCT#/TITLE AMOUNT l
1096-32 1315352 4358400 $ 25.00 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
4-Aug 2014
Signature
$ 25.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund