187043 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 364266 Page 1 of 1
ONE CIVIC SQUARE SARAH STEWART- SCHULTZE
f CARMEL, INDIANA 46032 14764 REDCLIFF DR CHECK AMOUNT: $48.00
NOBLESVILLE IN 46062 CHECK NUMBER: 187043
CHECK DATE: 6/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 435641 48.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 435641
Payment Date: 06/08/10
Household 15517
t►'7 17 Sr 5'0 F
Monon Community Center JU U 201 li-i Sarah Stewart Schultze Hm Ph: (317)566 -0262
Carmel IN 46032 14764 Redcliff Dr Wk Ph: (317)655 -7309
Noblesville IN 46062 Cell Ph:
BY: schultze86 @yahoo.com
Phohe: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 48.00
Enrollee Name: Augustus Schultze Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 103009 -06 Learn to Swim LVI 4 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 04/06/2010 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Outdoor Lap Pool 4 Class Dates: 06/14/2010 to 06/17/2010
Monon Community Cntr 8:05A to 9:OOA
M,Tu,W,Th
Carmel IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: advance request
G/L Code Description Account Number Cs Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 48.00 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 06/08/10 13:56:19 by CEK FEES CHANGED ON CANCELLED ITEMS 55.00
SURCHARGE APPLIED AGAINST CANCELLED FEES O 7.00
NET`AMOUNT FROM;CANCELLEDa1TEMS z 4&0048
sTOTi4L °AMOUNT',REF,..UNDED.E:, y ,48:00`
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 48.00 Made By REFUND FINAN With Reference advance request
Rewards Points refunded on this receipt: 0.70
Household Reward Point Balance: 0.70
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.
(a P f�
Authorized Signature Date Authorized Signature Date
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.
Stewart Schultze, Sarah Terms
14764 Redcliff Dr Date Due
Noblesville, IN 46062
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
618110 435641 Refund 48.00
Total 48.00
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.
Stewart Schultze, Sarah Allowed 20
14764 Redcliff Dr
Noblesville, IN 46062
In Sum of
48.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -10 435641 4358400 48.00 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
17 -Jun 2010
Signature
48.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund