HomeMy WebLinkAbout194263 02/03/2011 CITY OF CARMEL, INDIANA VENDOR: 365049 Page 1 of 1
ONE CIVIC SQUARE CHARLOTTE LIPPERT CHECK AMOUNT: $30.00
a CARMEL, INDIANA 46032 12785 FORSYTH ST
CARMEL IN 46032 CHECK NUMBER: 194263
CHECK DATE: 213!2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4358400 30.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt 561375
Payment Date: 01/14/11
Household 16816
West Clay Elementary Charlotte Lippert Hm Ph: (317)519 -7421
3495 W. 126th St. JAN 19 2011 LJ 12785 Forsyth St
Carmel IN 46032 Carmel IN 46032 Cell Ph:
Phone: (317)844 -9961 E7 douglas.lippert @gmail.com
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 30.00
Enrollee Name: Claire Weems Fees Tax discount Prev Paid Cur Paid Amount Due
Activity Number: 486101 -02 Acting 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 12/08/2010 (Cancelled)
Class Location: West Clay Elementary Class Dates: 01!1812011 to 02/08/2011
West Clay Elementary 2:45P to 3:45P
3495 W. 126th St. Tu
Carmel, IN 46032 Scheduled Sessions: 4
(317)844 -9961
Cancel Reason: low enrollment
PREVIOUS NET HOUSEHOLD BALANCE 0,00
Processed on 01/14/11 17:12:31 by JLH FEES CHANGED ON CANCELLED ITEMS 30.00
NET•AMOUNT'FROM:CANCELLEb, 30 Ott
TOTAL`AMOUNT`REFUNDED :.a
NEW NET HOUSEHOLD BALANCE 0.00
Refund of iQLQ By REFUND FINAN With Reference
All refund are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. N cash or credit card refunds.
Aut d Signature Date Authorized Signature Date
Mothers, bring your little prince to Prince Charming's Ball and share a Valentine's evening of enchantment and wonder at this
ballroom -style event. The event will be held on Friday, February 4 from 6 -9pm at the MCC. Fee is $15/person. Register at
www.carmelclayparks.com. Pre registration is required (activity# 319047 -01).
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.
Terms
Lippert, Charlotte
Date Due
12785 Forsyth St
Carmel, IN 46032
Invoice Invoice Description
Amount
Date Number (or note attached invoice(s) or bill(s))
30.00
1114111 561375 Refund
Total 30.00
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.
Lippert, Charlotte Allowed 20
12785 Forsyth St
Carmel, IN 46032
In Sum of
30.00
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT 41TITLE AMOUNT Board Members
Dept
1081 -99 561375 4358400 30.00 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
27 -Jan 2011
Signature
30.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund