189451 08/31/2010 CITY OF CARMFL, INDIANA VENDOR: 364644 Page 1 of 1
ONE CIVIC SQUARE MARY JANE OAKLEY
CARMEL, INDIANA 46032 9941 HAMBLIN COURT CHECK AMOUNT: $12.00
INDIANAPOLIS IN 46280 CHECK NUMBER: 181411
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CHECK DATE: 8!31!2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 12.00 PARKS DEPARTMENT REFU
i
I
ACTIVITY REFUND RECEIPT
Receipt 509573
Payment Date: 08/19/10
Household 81
Monon Community Center Mary Jane Oakley Hm Ph: (317)581 -0331
Carmel IN 46032 9941 Hamblin Ct
Indianapolis IN 46280 Cell Ph:
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 12.00
Enrollee Name: Mary Jane Oakley Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 107002 -03 Bridge Practice Play 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 05/24/2010 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Program Room A Class Dates: 08/18/2010 to 08/18/2010
Monon Community Cntr 6:45P to 8:15P
W
Carmel, IN 46032 Scheduled Sessions: 1
(317)848 -7275
Cancel Reason: Staff Sick
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 08/19/10 09:51:09 by MM FEES CHANGED ON CANCELLED ITEMS 12.00
NET AMOUNT FROM CANCELLED ITEMS 12.00
TOTAL AMOUNT REFUNDED 12.00'
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 1200 Made By REFUND FINAN With Reference staff sick
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. c r cr it card refunds.
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Authoriz d Signature ate A6 Krized ?gnature d at d
IM(, SG. 43SNOa
ENJOY YOUR ESCAPE!!! �yy
AUG 1 y 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.
Oakley, Mary Jane Terms
9941 Hamblin Ct. Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/19110 509573 Refund 12.00
i
Total 12.00
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.
Oakley, Mary Jane Allowed 20
9941 Hamblin Ct.
Indianapolis, IN 46280
In Sum of
12.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #ITITLE AMOUNT Board Members
Dept
1096 -50 509573 4358400 12.00 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
12.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund