242693 03/03/15 ,Cqq
l J; CITY OF CARMEL, INDIANA VENDOR: 369151
® •I• ONE CIVIC SQUARE SUZANNE BUCKNER CHECK AMOUNT: $ •`•••"10.00'
CARMEL, INDIANA 46032 7434 KING GEORGE DR CHECK NUMBER: 242693
INDIANAPOLIS IN 46260 CHECK DATE: 03/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 1412890 10.00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 1412890
Carmel 0 CI?Y
Pament ue: 02/ 315
s�
r e�creation Hosehold# 2
Monon Community Center FEB 2 5 2015 Suzanne Buckner Hm Ph: (317)254-9460
Carmel IN 46032 7434 King George Dr.
" . Indianapolis IN 46260 Cell Ph:(317)752-1939
Phone: (317)848-7275 letsbelight32@gmail.com
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION -Refund Of 10.00
Enrollee Name: Suzanne Buckner Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 358045-01 Sweet Hearts Formal 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 02/21/2015 (Cancelled)
Class Location: Multipurpose Rm-A113 Class Dates: 02/21/2015 to 02/21/2015
Monon Community Cntr 7:OOP to 10:OOP
Sa
Carmel, IN 46032 Scheduled Sessions: 1
(317)848-7275
Cancel Reason: Visit Refund
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 02/24/15 @ 14:37:14 by MYADON FEES CHANGED ON CANCELLED ITEMS(+) '10.00-
NET AMOUNT FROM CANCELLED ITEMS' 10.00-
TOTAL AMOUNT REFUNDED. 10.00"
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 10.00 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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uthorized Si atur 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.
Buckner, Suzanne Terms
7434 King George Dr Date Due
Indianapolis, IN 46260
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/24/15 1412890 Refund $ 10.00
Total $ 10.00
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.
Buckner, Suzanne f iAllowed 20
7434 King George Dr
.Indianapolis, IN 46260
In Sum of$
$ 10.00
ON ACCOUNT OF APPROPRIATION FOR j
109 -MCC (.
I
PO#or Board Members
De t# INVOICE NO. ACCT#/TITLE AMOUNT
P '.
1096-70 1412890 4358400 $ 10.00 j 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
February 26, 2015
I
I
I
I
Signature
$ 10.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund