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181897 02/03/2010 �i CITY OF CARMEL, INDIANA VENDOR: 363850 Page 1 of 1 o, c ONE CIVIC SQUARE CARRYN ETCHER CHECK AMOUNT: $54.00 i CARMEL, INDIANA 46032 CARMEL IN 46033 CHECK NUMBER: 181894 CHECK DATE: 2/312010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4358400 54.00 REFUNDS AWARDS INDE ACTIVITY REFUND RECEIPT n Receipt 377667 g Payment Date: 01/15/10 Household 8567 JAN 222010 Mohawk Trails Elemen Carryn Fletcher Hm Ph: (317)815 -9550 4242 East 126th Street 13239 Blacktern Way Carmel IN 46033 Carmel IN 46033 Cell Ph: jcfletch ©indy.net Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Enrollment Details CANCELLATION Refund Of 24.00 Enrollee Name: Marie Fletcher Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 486051 -03 Tumbling 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 12/14/2009 (Cancelled) Class Location: Mohawk Trails Elem Class Dates: 01/20/2010 to 02/10/2010 Mohawk Trails Elemen 2:45P to 3:45P 4242 East 126th Street W Carmel, IN 46033 Scheduled Sessions: 4 (317)848 -7275 Cancel Reason: low enrollment G/L Code Description Account Nuinber Cst Cntr Description Account Number Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 54.00 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 CREDIT HOUSEHOLD BALANCE 30.00 Processed on 01/15/10 16:22:25 by KRM FEES CHANGED ON CANCELLED ITEMS 24.00 r NET •AMOUNT.FROM:CANCELLED'ITEMS 24:09- i) HH BALANCE APPLIED TO THIS RECEIPT( 30.00 TOTAL "AMOUNT'REFUNDED NEW NET HOUSEHOLD BALANCE 0.00 Refund of 54.00 Made By REFUND FINAN With Reference All refun• are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be issued. fo cash or credit card ref •s. Author Signature �x�-y..)� Date Authorized Signature Date L1 S (1 -100 r 4 3c5 2 q5-11 /35 1L/o 0 r 2 -E )1\- 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. Fletcher, Carryn Terms 13239 Blacktern Way Date Due Carmel, I N 46033 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 1/15/10 377667 Refund 54.00 Total 54.00 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. Fletcher, Carryn Allowed 20 13239 Blacktern Way Carmel, IN 46033 In Sum of$ 54.00 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or Board Members INVOICE NO. ACCT #/TITLE AMOUNT Dept 1081 377667 4358400 54.00 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 28 -Jan 2010 Signature 54.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund