HomeMy WebLinkAbout186419 06/09/2010 CITY OF CARMEL, INDIANA VENDOR: T356046 Page 1 of 1
ONE CIVIC SQUARE KELLY MASIN CHECK AMOUNT: $5,00
CARMEL, INDIANA 46032 14191 NICHOLAS DRIVE
WESTFIELD IN 45074 CHECK NUMBER: 186419
CHECK DATE: 6!912010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 5.00 REFUND
ACTIVITY REFUND RECEIPT
Receipt 413007
Payment Date: 04/16/10
Household 5754
Morten Center Kelly Masin Hm Ph: (317)843 -1686
Carmel IN 46032 14191 Nicholas Dr
Westfield IN 46074 Cell Ph: (317)250 -2180
kellymasin @aol.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION
Enrollee Name: Andrew Masln Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 306425 -02 Safe Sitter 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 02/0512010 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Program Rms A, B, C Class Dates: 04/24/2010 to 04/24/2010
Monon Center 9:OOA to 4:OOP
Sa
Carmel IN 46032 Scheduled Sessions: 1
(317)848 -7275
GL Co_de Description_ Account_ Number__ Cst_Cntr___ Description Account Number
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 5.00 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 5.00
Processed on 04/16/10 ®20:01:09 by LVA FEES CHANGED ON CANCELLED ITEMS 0.00
NET AMOUNT FROM CANCELLED ITEMS 0.00
HH BALANCE APPLIED TO THIS RECEIPT 5.00
TOTAL AMOUNT REFUNDED 5.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 5.00 Made By REFUND FINAN With Reference
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. No cash or credit card refunds.
DiL (10 11
1 Authorized Sign a Date Author ed Signature IT
joy i.� a /cc) MAY i 2010
3
BY:
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.
Masin, Kelly Terms
14191 Nicholas Dr Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/16/10 413007 Refund 5.00
Total 5.00
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.
Masin, Kelly Allowed 20
14191 Nicholas Dr
Westfield, IN 46074
In Sum of
5.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1096 -42 413007 4358400 5.00 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
3 -Jun 2010
Signature
5.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund