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181535 01/20/2010 -'71N CITY OF CARMEL, INDIANA VENDOR: 363800 Page 1 of 1 ONE CIVIC SQUARE SHERARD CLINKSCALES CHECK AMOUNT: $15.00 CARMEL, INDIANA 46032 2121 GRENVILLE ST 1,.; APTD CARMEL IN 46032 CHECK NUMBER: 181535 CHECK DATE: 1/20/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4358400 372573 15.00 REFUNDS AWARDS INDE ACTIVITY REFUND RECEIPT Receipt 372573 Payment Date: 01/08/10 Household 31094 Monon Center Sherard Clinkscales Hm Ph: (317)506 -5212 Carmel IN 46032 2121 Grenville Street, Apt D AN 1 2 2010 Carmel IN 46032 Cell Ph: ©comcast. net Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Enrpliment Details Enrollee Name: Tara Clinkscales Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 306374 -03 Beginner Taekwondo 100.00 0.00 0.00 100.00 0.00 Enrollment Date: 01/08/2010 (Enrolled Transfer from 306374 -01 (Beginner Taekwondo)) Primary Instructor: Indy Taekwondo Class Location: Gymnasium C Class Dates: 03/08/2010 to 04/28/2010 Monon Center 6:OOP to 6:50P M,W Carmel, I N 46032 Scheduled Sessions: 14 (317)848 -7275 Skip Days 04/05/2010, 04/07/2010 G/L Code Description Account Number Cst Cntr Description Account Number Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 15.00 DR The REVENUE account was DEBITED and the CONTROL account was CREDITED on the day of the refund. Finance will have to DEBIT the CONTROL account for the amounts listed above after the checks have been written to the customers. PREVIOUS NET HOUSEHOLD BALANCE 0.00 Processed on 01/08/10 10:15:58 by LVA FEES ADJUSTED ON CHANGED ITEMS 15.00- I NET AMOUNT FROM CHANGED ITEMS 15.00 TOTAL AMOUNT REFUNDED 15.00 NEW NET HOUSEHOLD BALANCE 0.00 Refund of 15.00 Made By REFUND FINAN With Reference advanced request Payment of 100.00 Made By Activity Registration Credit Balance All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be issue. 'o cash or credit card refunds. 1110 Y� ate Authorized 4ature Autd Signature D to H 7 lx L LI OQ 4 \iaccd Page 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. Clinkscales, Sherard Terms 2121 Grenville Street, Apt D Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 1/8/10 372573 Refund 15.00 Total 15.00 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 Voucher No. Warrant No. Clinkscales, Sherard Allowed 20 2121 Grenville Street, Apt D Carmel, I N 46032 In Sum of$ 15.00 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or Board Members INVOICE NO. ACCT #ITITLE AMOUNT Dept 1096 -42 372573 4358400 15.00 I 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 14 -Jan 2010 Signature 15.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund