187495 07/07/2010 f CITY OF CARMEL, INDIANA VENDOR: 364328 Page 1 of 1
Q� ONE CIVIC SQUARE HOLLY WININGS
CARMEL, INDIANA 46032 9680 N SHELBORNE RD CHECK AMOUNT: $160.00
CARMEL IN 46032 CHECK NUMBER: 187495
CHECK DATE: 7/712010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 449886 160.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 449886
Payment Date: 06/22/10
Household 35526
Mohawk Trails Elemen Holly Winings Hm Ph: (317)289 -3435
4242 East 126th Street 9680 N. Shelborne Rd Wk Ph: (317)253 -7950
Carmel IN 46033 Carmel IN 46032 Cell Ph: (317)373-6254
imgunn @gmaii.com
Phone: (317)848 -7275
Fed Tax I D #35- 6000972
Enrollment Details
CANCELLATION Refund Of 160.00
Enrollee Name: Mackenzie Winings 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: 06/0712010 (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: child not on spectrum
GIL Code Description Acc ount Number C st Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP)� Enter Control Acct here 160.00 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 06/22/10 11.05:50 by CMC FEES CHANGED ON CANCELLED ITEMS 160.00
NET AMOUNT FROM CANCELLED ITEMS''. 160 00
TOTAL AMOUNTREFUNDED'_
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 160.00 Made By REFUND FINAN With Reference
All refunds re subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. N cash or credit card refunds.
t7 4ignature Date Authorized Signature Date
JUN 2 3 2010
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.
Winings, Holly Terms
9680 N. Sheiborne Rd Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) Amount
160.00
6/22110 449886 Refund
Total 160.00
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- 14 -1.6
20�
Clerk- Treasurer
Voucher No. Warrant No.
Winings, Holly Allowed 20
9680 N. Shelborne Rd
Carmel, IN 46032
In Sum of
160.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #ITITLE AMOUNT Board Members
Dept
1082 -8 449886 4358400 160.00 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
160.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund