187291 07/07/2010 CITY OF CARMEL, INDIANA VENDOR: 364306 Page 1 of 1
0 ONE CIVIC SQUARE TRACY FISHER CHECK AMOUNT: $40.00
CARMEL, INDIANA 46032 1420 JEFFREY CT
CARMEL IN 46032 CHECK NUMBER: 187291
CHECK DATE: 7/7/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 445354 40.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 445354
Payment Date: 06/17/10
Household 17294
Monon Community enter IJUN ty 3 Z0 0 Tracy Fisher Hm Ph: (317)663 -7698
Carmel IN 46032 1 Jeffrey Ct.
Carmel IN 46032 Cell Ph:
By. tracyfisher418 @yahoo.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 40.00
Enrollee !Jame: Tracy Fisher Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 109002 -01 Family Campout 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 05/2512010 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: West Park Field Class Dates: 06/11/2010 to 06/12/2010
West Park 4:30P to 9:00A
2700 W. 116th St. F,Sa
Carmel, IN 46032 Scheduled Sessions: 2
(317)848 -7275
Cancel Reason: advanced request
GIL Code_ Description Account Number Cst Cntr Description Ac count N umber_ Amo
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 40.00 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!17!10 15:43:13 by SAC FEES CHANGED ON CANCELLED ITEMS 40.00
NET AMOUNT FROM CANCELLED ITEMS 40.00-
TOTAL AMOUNT REFUNDED 40.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 40.00 Made By REFUND FINAN With Reference advanced request
refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
iss ed. No c sh or c it card refunds. &13W &4 6 b- 0
17-l
Authorized Signature Date Auth ized Signature Date
Lo uo s4m
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.
Fisher, Tracy Terms
1420 Jeffrey Ct. Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/17/10 445354 Refund 40.00
Total 40.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Fisher, Tracy Allowed 20
1420 Jeffrey Ct.
Carmel, IN 46032
In Sum of
40.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1096 -60 445354 4358400 40.00 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
1 -Jul 2010
Signature
40.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund