245633 05/20/15 ,,�('+u,CSN*t
�;;. CITY OF CARMEL, INDIANA VENDOR: 369402
d i ONE CIVIC SQUARE WEN-CHIN TSAI CHECK AMOUNT: $ 346.00'
?� CARMEL, INDIANA 46032 12913 TRADD STREET APT 3D CHECK NUMBER: 245633
'M�roN.� CARMEL IN 46032 CHECK DATE: 05/20/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 1444894 346.00 REFUNDS AWARDS & INDE
ti GLOBAL REFUND RECEIPT
a- rte. Receipt# 1444894
Carmel � Clay � Payment Date: 05/13/15
Darks&Rccrcafiof� MAY 55 2015 Household #: 59074
�Y:
Monon Community Center Wen-Chin Tsai Hm Ph: (317)771-2543
Carmel IN 46032 12913 Tradd street, Apt 3D Wk Ph: (317)771-2543
Carmel IN 46032 Cell Ph:(317)771-2543
fangling0103@gmail.com
Phone: (317)848-7275
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION - Refund Of 166.00
Enrollee Name: Teng-Lei Tsai Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476009-06 Move to Improve 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 01/02/2015 (Cancelled)
Class Location: Clay Middle School Class Dates: 07/06/2015 to 07/10/2015
Clay Middle School 8:OOA to 5:30P
5150 East 126th Street M,Tu,W,Th,F
Carmel, IN 46033 Scheduled Sessions: 5
(317)848-7275
Cancel Reason: parent request
CANCELLATION -Refund Of 180.00
Enrollee Name: Tsan-Yang Tsai Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476009-06 Move to Improve 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 01/02/2015 (Cancelled)
Class Location: Clay Middle School Class Dates: 07/06/2015 to 07/10/2015
Clay Middle School 8:OOA to 5:30P
5150 East 126th Street M,Tu,W,Th,F
Carmel, IN 46033 Scheduled Sessions: 5
(317)848-7275
Cancel Reason: parent request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 05/13/15 @ 16:07:48 by JAB FEES CHANGED ON CANCELLED ITEMS(+) 360.00-
SURCHARGE APPLIED AGAINST CANCELLED FEES(-) 14.00-
NET AMOUNT FROM CANCELLED ITEMS
TOTAL AMOUNT AMOUNT REFUNDED 346.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 346.00 Made By=_> FUND FINAN With Reference==>parent request;82-10-4358400 refund
All refunds 'ect tate Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be
issue( . I
l
thorize Signature Date Authorized Signature Date
Page# 1 of 2
GLOBAL REFUND RECEIPT
�'� I � .7�J Receipt# 1444894
'marks&Recreation Payment Date: 05/13/2015
Household #: 59074
Escape Day Passes are non-refundable.
Page# 2 of 2
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.
Tsai, Wen-Chin Terms
12913 Tradd Street Apt. 3D Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/13/15 1444894 Refund $ 346.00
Total $ 346.00
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.
Tsai, Wen-Chin Allowed 20
12913 Tradd Street Apt. 3D
Carmel, IN 46032
In Sum of$
$ 346.00
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1082-10 1444894 4358400 $ 346.00 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
May 15, 2015
Signature
$ 346.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund