193714 01/19/2011 CITY OF CARMEL, INDIANA VENDOR: T357558 Page 1 of 1
ONE CIVIC SQUARE LAURA DANIELS
s 0 CHECK AMOUNT: $27.50
CARMEL, INDIANA 46032 11414 PERKINS ST
CARMEL IN 46032 CHECK NUMBER: 193714
CHECK DATE: 1/19/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 27.50 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt 557078
Payment Date: 01/04/11
Household 522
Monon Community Center Laura Daniels Hm Ph: (317)815 -4697
Carmel IN 46032 11414 Perkins St. Wk Ph: (317)
Carmel IN. 46032 Cell Ph: (317),371-0050
laura.daniels7 @sbcglobal.net
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
ROSTER CHANGE Refund Of 13.75
Enrollee Name: Connor Daniels Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number. 315259 -01 Preschool Gymnastics 41.25 0.00 41.25 0.00 0.00
Enrollment Date: 1210112010 (Enrolled)
Class vocation: Dance Studio B Class Dates: 01/0412011 t601/25/2011
Monon Community Cntr 1V15A to 11:45A.
Tu
Carmel, IN 46032 Scheduled Sessions: 4
(317)848 -7275
ROSTER CHANGE Refund Of 13.75
Enrollee Name: Leanne Daniels Fees Tax discount Prev Paid Cur Paid Amount Due
Activity. Number: 315259.01 Preschool Gymnastics 41.25 0.00 41.25 0.00 0.40
Enrollment Date: 12/01/2010 (Enrolled)
Class Location: Dance Studio B Class Dates: 01/04/2011 to 01125/2011
Monon Community Cntr 11:15A to 11:45A
Tu
Carmel, IN 46032 Scheduled Sessions: 4 L ,J Q
(317)848 -7275 6.._/
r
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 01104/11 09 :44:53 by CNA FEES ADJUSTED ON CHANGED ITEMS 27.50
NET, AMOUNT FROM CHANGED ITEMS 27.50
TOTAL AMOUNT. REFUNDED 27.50
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 27.50 Made By REFUND FINAN With Reference instrWor sick
All refunds are subject to. State Board of Accounts claim procedure and may take weeks to process. A check will be
issued. No cash or credit card refunds.
A prized Signature ZAW4, Signatu ate
1090. 3 y35 �3g Page #1
sick
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,
Daniels, Laura Terms
11414 Perkins St. Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
114111 557078 Refund 27.50
Total 27.50
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with 1C 5- 11- 10 -1.6
20_
Clerk- Treasurer
Voucher No, Warrant No.
Daniels, Laura Allowed 20
11414 Perkins St.
Carmel, IN 46032
In Sum of$
27.50
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -32 557078 4358400 27.50 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
13 -Jan 2011
Signature
27.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund