163879 09/17/2008 CITY OF CARMEL, INDIANA VENDOR: T361816 Page 1 of 1
j� ONE CIVIC SQUARE NINETTE BUSCHUR CHECK AMOUNT: $63.00
1, CARMEL, INDIANA 46032 13570 KINGSBURY DRIVE
CARMEL IN 46032
CHECK NUMBER: 163879
CHECK DATE: 9/17/2008
DEPA ACCOUNT PO N UMBER INVOICE NUMBER AM OUNT DESCRIPTION
1047 4358400 182991 63.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
1
Receipt 182991
Payment Date: 08/30/2008
Household 5841
Home Phone: (317)843 -1426
Work Phone: SEP
2008
BY:
NINETTE BUSCHUR Monon Center
13570 KINGSBURY DRIVE Carmel IN 46032
2 CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 63.00
Enrollee Name. Daria Buschur Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 286447 -01 Baton 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 08/2212008 (Cancelled)
Primary Instructor: Tumble Time
Class Location: Gymnasium B Class Dates: 08(30/2008 to 10104/2008
Monon Center 10:30A to 11:OOA
Sa
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 6
Cancel Reason: low enrollment
GIL Code Description Account Number Cst Cntr Descrip_tion Account Number Amou
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 63.00 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 08130(08 20:27:30 by CNA FEES CHANGED ON CANCELLED ITEMS 63.00-
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 63.00
TOTAL AMOUNT REFUNDED 63.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 63.00 Made By REFUND FINAN With Reference low enrollment
Page 1
ACTIVITY REFUND RECEIPT
Receipt 182999
Payment Date: 08/30/08
Household 5841
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
Issued. No cash or credit card refunds.
Aut6ized Signature Date Authorized Signature Date
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.
Buschur, ninette Terms
13570 Kingsbury Drive Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8130/08 182991 Refund 63.00
Total 63.00
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.
Buschur, ninette Allowed 20
13570 Kingsbury Drive
i Carmel, IN 46032
In Sum of
63.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept
1047 182991 4358400 63.00 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
4 -Sep 2008
Signature
63.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund