187933 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 364428 Page 1 of 1
ONE CIVIC SQUARE TAK LEE CHECK AMOUNT: $224.00
CARMEL, INDIANA 46032 1311 BROOKSLANDING PLACE
CARMEL IN 46033 CHECK NUMBER: 187933
CHECK DATE: 7/21/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 467202 224.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 467202
Payment Date: 07/08/10
Household 29234
Monon Community Center Tak Lee Hm Ph: (317)818 -1888
Carmel IN 46032 1311 Brookslanding Place
Carmel IN 46033 Cell Ph:
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 112.00
Enrollee Name: Loraine Lee Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 106372 01 Dancing Little Star 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 06/16/2010 (Cancelled)
Primary Instructor: Int Talent Academy
Class Location: Dance Studio B Class Dates: 07/12/2010 to 08/30/2010
Monon Community Cntr 4:30P to 5:20P
M
Carmel IN 46032 Scheduled Sessions: 8
(317)848 -7275
Cancel Reason: low enrollment
CANCELLATION Refund Of 112.00
Enrollee Name: Megan Lee Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 106372 01 Dancing Little Star 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 06/16/2010 (Cancelled)
Primary Instructor: Int Talent Academy
Class Location: Dance Studio B Class Dates: 07/12/2010 to 08/30/2010
Monon Community Cntr 4:30P to 5:20P
M
Carmel IN 46032 Scheduled Sessions: 8
(317)848 -7275
Cancel Reason: low enrollment
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/08/10 12:22:41 by LVA FEES CHANGED ON CANCELLED ITEMS 224.00
y 9a^ NET AMOUNT FROM CANCELLED ITEMS 224.00
J U L 1 4 2 0 1 0 ya I TOTAL AMOUNT REFUNDED 224.00
]By NEW NET HOUSEHOLD BALANCE 0.00
Refund of 224.00 Made By REFUND FINAN With Reference low enrollment
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued o cash or credit card refunds.
7 l 3 1C)
Page 1
04 U �f a- q �S—Po0
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.
Lee, Tak Terms
1311 Brookslanding Place Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
718/10 467202 Refund 224.00
Total 224.00
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.
Lee, Talk Allowed 20
1311 Brookslanding Place
Carmel, IN 46033
In Sum of
224.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -42 467202 4358400 224.00 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
15 -Jul 2010
Signature
224.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund