161203 07/08/2008 a f CITY OF CARMEL, INDIANA VENDOR: T361483 Page 1 of 1
f, ONE CIVIC SQUARE CHRISTINA CAMPINS CHECK AMOUNT: $191.00
CARMEL, INDIANA 46032 5111 HUMMINGBIRD CIRCLE
CARMEL IN 46033 CHECK NUMBER: 161203
CHECK DATE: 7/8/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 133630 191.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT 7BY: V
ED
Receipt# 133630 2008
Payment Date: 06/17/2008
Household 6484
Home Phone (317)574 1969
Work Phone: (317)460 -0140
CHRISTINA CAMPINS Carmel Clay Parks Recreation
5111 HUMMINGBIRD CIRCLE 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 23.00
Enrollee Name: Isabella Campins Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 186352 -01 Wear Your Creations 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 05130/2008 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Program Room C Class Dates: 06/19/2008 to 07/17/2008
Monon Center 5-OOP to 6:001
Th
Carmel, IN 46032 Skip Days 07/03/2008
(317)848 -7275 Scheduled Sessions. 4
Cancel Reason: low enrollment
G/L Code Description Account Num Cst Cntr Description Account Number Amo
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 191_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 CREDIT HOUSEHOLD BALANCE 168.00
Processed on 06 /17 /08 09:27:33 by BJC FEES CHANGED ON CANCELLED ITEMS 23.00-
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT CANCELLED ITEMS 23.00
HH BALANCE APPLIED TO THIS RECEIPT 168.00
TOTAL AMOUNT REFUNDED 191.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 191.00 Made By JOURNAL -RF With Reference low enrollmenUhh
Page 1
ACTIVITY REFUND RECEIPT
Receipt 133630
Payment Date: 06/17/08
Household 6484
All refunds are subject to State Board of-Accounts claim procedure and ma take 4 -6 w ks to process. A check will be
issued. No cash or credit card refunds. P
P n- C., `-C I' 1 I A
uthoriz gMq nature Date Authorized S gnature D to
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.
Campins, Christina Terms
5111 Hummingbird Circle Date Due
Carmel, IN 46033
rf
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6117108 133630 Refund 191.00
Total 191.00
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,
Campins, Christina Allowed 20
5111 Hummingbird Circle
Carmel, IN 46033
In Sum of
191.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 133630 4358400 191.00 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 -Jun 2008
1j I �C�'l 1� 1ti? YL -A)
Signature
191.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
T.