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155662 01/23/2008 CITY OF CARMEL, INDIANA VENDOR: 360719 Page 1 of 1 ONE CIVIC SQUARE JILL BUCK CARMEL, INDIANA 46032 5283 IVY HILL DR CHECK AMOUNT: $65.00 CARMEL IN 46033 CHECK NUMBER: 155662 CHECK DATE: 1/23/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1047 4358400 82607 65.00 REFUNDS AWARDS INDE L'� ACTIVITY REFUND RECEIPT Y Receipt 82607 Payment Date: 01/08/2008 Hou ehold 14275 Home Phone: (317)663 -4546 JAN I 2Tn0 Work Phone: JILL BUCK Carmel Clay Parks Recreation 5283 IVY HILL DRIVE 1235 Central Park Drive East CARMEL, IN 46033 Carmel IN 46032 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Enrollment Details CANCELLATION Refund Of 65.00 Enrollee Name: Andrew Buck Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 385003 -01 Lil' Kickers Jack Ra 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 12/19/2007 (Cancelled) Primary Instructor: Off the Wall Sports Class Location: Off The Wall Sports Class Dates: 01/07/2008 to 02/11/2008 Off the Wall Sports 11:30A to 12:15P 1423 Chase Court M Carmel, IN 46032 (317)340 -9086 Scheduled Sessions: 6 Cancel Reason: low enrollment G Co de Descrip Account Numbe Cst C ntr Descriptio Ac count Numb Am ount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 65.00 DR The REVENUE account was DEBITED and the CONTROL account was CREDITED on the day of the refund. Finance will have to DEBIT the CONTROL account for the amounts listed above after the checks have been written to the customers. PREVIOUS NET HOUSEHOLD BALANCE 0.00 Processed on 01/08/08 08:33:56 by BJC FEES CHANGED ON CANCELLED ITEMS 65.00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 NET AMOUNT FROM CANCELLED ITEMS 65.00 TOTAL AMOUNT REFUNDED 65.00 NEW NET HOUSEHOLD BALANCE 0.00 Refund Type: Refund from Finance Refund of 65.00 Made By JOURNAL -RF With Reference low enrollment Page 1 ACTIVITY REFUND RECEIPT Receipt 82607 Payment Date: 01/08/08 Household 14275 All refunds are sub' t to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be issue No cash or edit card refunds. I Authori d Signature Date Authorized Signa late Page #2 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. Jill Buck Terms 5283 Ivy Hill Dr. Date Due Carmel, IN 46033 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 118108 82607 Refund 65.00 Total 65.00 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. Jill Buck Allowed 20 5283 Ivy Hill Dr. Carmel, IN 46033 In Sum of 65.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members Dept 1047 82607 4358400 65.00 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 16 -Jan 2008 nat 65.00 Business S ices Manager Cost distribution ledger classification if Title claim paid motor vehicle highway fund