186774 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 364255 Page 1 of 1
ONE CIVIC SQUARE STEVEN COCHRAN CHECK AMOUNT: $313.00
CARMEL, INDIANA 46032 10253 RED TAIL DRIVE
FISHERS IN 46037 CHECK NUMBER: 186774
CHECK DATE: 6/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION
1082 4358400 440575 313.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 440575
Payment Date: 06/14/10
Household 7682
West Clay Elementary Steven Cochran Hm Ph: (317)579 -0560
3495 W. 126th St. 10253 Red Tail Drive Wk Ph: (317)506 -0569
Carmel IN 46032 Fishers IN 46037 Cell Ph: (317)506-0569
Phone: (317)844 -9961 Steve—cochran—battery@yahoo.com
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 153.00
Enrollee Name: Brett Cochran Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476004 -03 Alternative Minds 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 05/18/2010 (Cancelled)
Class Location: Orchard Park Elem Class Dates. 06 /14/2010 to 06/18/2010
Orchard Park Element 8:OOA to 4-OOP
10404 Orchard Park Drive South M,Tu,W,Th,F
Indianapolis, IN 46280 Scheduled Sessions: 5
(317)848 -7275
Cancel Reason: poor fit for camp this year.
CANCELLATION Refund Of 160.00
Enrollee Name: Brett Cochran Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476004 -04 Alternative Minds 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 05/18/2010 (Cancelled)
Class Location: Orchard Park Elem Class Dates: 06/21/2010 to 06/25/2010
Orchard Park Element 8:OOA to 4-OOP
10404 Orchard Park Drive South M,Tu,W,Th,F
Indianapolis, IN 46280 Scheduled Sessions: 5
(317)848 -7275
Cancel Reason: poor fit for camp this year.
wt� N cr ITIC mctT G4°tc VIA- NFIr C-9/0)
G/L Co Description Account Number Cst Cntr Descri Accou Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 313.00 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 06/14/10 14:22:39 by JLH FEES CHANGED ON CANCELLED ITEMS 320.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 7.00
NET AMOUNT, FROM:CANCELLEDJTEMS 313:00 =I
TOTAL AM0L1NT'REFUNDED 313:00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 313.00 Made By REFUND FINAN With Reference
t1
w Page 1
ACTIVITY REFUND RECEIPT
Receipt 440575
Payment Date: 06/14/2010
Household 7682
All refund re subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. check will be
issued. N cash or credit card refunds.
i
uthori Signature Date Authorized Signature Date
L
Page 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.
Cochran, Steven Terms
10253 Red Tail Drive Date Due
Fishers, IN 46037
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/14110 440575 Refund 313.00
i
Total 313.00
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
,20
Clerk- Treasurer
Voucher No. Warrant No.
Cochran, Steven Allowed 20
10253 Red Tail Drive
Fishers, IN 46037
In Sum of
313.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1082 -8 440575 4358400 313.00 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
17 -Jun 2010
Signature
313.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund