188127 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 364450 Page 1 of 1
ONE CIVIC SQUARE JEFF YESH CHECK AMOUNT: $48.00
CARMEL, INDIANA 46032 13915 NANSEMOND OR
CARMEL IN 46032 CHECK NUMBER: 188127
CHECK DATE: 7/2112010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 463205 48.00 REFUNDS AWARDS INDE
4
ACTIVITY REFUND RECEIPT
Receipt 463205
Payment Date: 07/05/10
Household 22180
Monson Community Center Jeff Yesh Hm Ph: (317)580 -0657
Carmel IN 46032 13915 Nansemond Drive
Carmel IN 46032 Cell Ph:
lorimatu @hotmail.com
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 48.00
Enrollee Name: Keira Yesh Fees +Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 105241 -03 Beautiful Ballerina 17.00 0.00 0.00 17.00 0.00
Enrollment Date: 06/07/2010 (Cancelled)
Class Location: Dance Studio B Class Dates: 06/15/2010 to 08/03/2010
Monon Community Cntr 11:45A to 12:15P
Tu
Carmel IN 46032 Scheduled Sessions: 8
(317)848 -7275
Cancel Reason: prorated request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/05110 08:50:24 by CNA FEES CHANGED ON CANCELLED ITEMS 65.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 17.00
NET AMOUNT FROM CANCELLED ITEMS 48.00
TOTAL AMOUNT REFUNDED 48.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 48.00 Made By REFUND FINAN With Reference prorated request
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.
I'Law �U"
7 5 I C1'i 5 i c�
AutftArized Signature Date Authori ed Signature (g Date
UU J U t_ 6 6 2010
BY........................
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P t Dyav eJ 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.
Yesh, Jeff Terms
13915 Nansemond Dr Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/5/10 463205 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.
Yesh, Jeff Allowed 20
13915 Nansemond Dr
Carmel, IN 46032
In Sum of
a
48.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -32 463205 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
15 -Jul 2010
Signature
48.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund