189425 08/31/2010 CITY OF CARMEL, INDIANA VENDOR: 364642 Page 1 of 1
ONE CIVIC SQUARE SUSUAN MARLEY
0 CHECK AMOUNT: $7.00
CARMEL, INDIANA 46032 4709 BRIARWOOD TRACE
CARMEL IN 46033 CHECK NUMBER: 189425
CHECK DATE: 8/3112010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 7.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 509798
Payment Date: 08/19/10
Household 32082
Monon Community Center Susan Marley Hm Ph: (317)844 -9360
Carmel IN 46032 4709 Briarwood Trace Wk Ph: (317)571 -4084
Carmel IN 46033 Ext. 1711
'Phone: (317 )848 -7275 booklady @indy.rr.com Cell Ph:
Fed Tax ID #35- 6000972
Enrollment Details
ROSTER CHANGE Refund Of 7.00
Enrollee Name: Andrea Marley Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 104201 -09 Zumba 28.00 0.00 28.00 0.00 0.00
Enrollment Date: 04/16/2010 (Enrolled)
Class Location: Dance Studio Class Dates: 08/02/2010 to 08/23/2010
Monon Community Cntr 7:OOP to 7:50P
M
Carmel IN 46032 Scheduled Sessions: 4
(317 )848 7275
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 08119/10 13:2820 by LWW FEES ADJUSTED ON CHANGED ITEMS 7.00-
NET.AMOUNT FROM CHANGED.ITEMS 7;00
T.OTALAMOUNT REFUNDED 7.00:
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 7.00 Made By REFUND FINAN With Reference Class cancelled 8130
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issu ed. No cash or credit card refunds.
W iloLck C,
Authorized Signature Date Authorized Si ature Date
ENJOY YOUR ESCAPE!!!
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Page 1
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL rmed
An invoice of bill to be properly itemized must ow; k ind of service, where rice er ounit a dates service rendered, by c.
whom, rates per day, number of hours, rite per
Payee Purchase Order No.
Terms
Marley, Susan Date Due
4709 Briarwood Trace
Carmel, 1N 46033
Invoice Invoice Description Amount
Date Number (or note attached invoices) or bill(s)) 7.00
8119110 509798 Refund
Total 7.00
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.
Marley, Susan Allowed 20
4709 Briarwood Trace
Carmel, IN 46033
In Sum of
7.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #1T1TLE AMOUNT Board Members
Dept
1096 -22 509798 4358400 7.00 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
26 -Aug 2010
Signature
7.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund