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Home My WebLink About198168 06/06/2011 CITY OF CARMEL, INDIANA VENDOR: 365396 Page 1 of 1 ONE CIVIC SQUARE STEPHANIE KHAN CARMEL, INDIANA 46032 3647 E CARMEL DRIVE CHECK AMOUNT: $698.00 CARMEL IN 46033 CHECK NUMBER: 198168 CHECK DATE: 616/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1082 4358400 698.00 REFUNDS AWARDS INDE ACTIVITY REFUND RECEIPT Receipt 618818 Payment Date: 05/19/11 Household 3979 Monon Community CenterF s Stephanie Khan Hm Ph: (317)816 -1413 Carmel IN 46032 t`- JUN 0 3 3647 E. Carmel Drive Carmel IN 46033 Cell Ph: By: .a, skhanl @indy.rr.com Phone: {317)848 -7275 Fed Tax ID #35- 6000972 Enrollment Details CANCELLATION Refund Of 68.00 Enrollee v Number: Fees Disc ity mber: 476003 04 Outdoor Explorers 0.00 O 0 Prev P Cur Paid 0 0.00 0-00 0 Amount 0.00 Enrollment Hate: 01114/2011 (Cancelled) Class Location: Meeting House Class Dates: 06/20/2011 to 06/24/2011 Meeting House 8:30A to 4:30P 1507 E. 116th Street M,Tu,W,Th,F Carmel, IN 46032 Scheduled Sessions: 5 (317)848 -7275 Cancel Reason: moving out of state CANCELLATION Refund Of 60.00 Enrollee Name: Cameron Khan Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476003 -06 Outdoor Explorers 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01/14/2011 (Cancelled) Class Location: Meeting House Class Dates: 07/05/2011 to 07/08/2011 Meeting House 8:30A to 4:30P 1507 E. 116th Street Tu,W,Th,F Carmel, IN 46032 Scheduled Sessions: 4 (317)848 -7275 Cancel Reason: moving out of state CANCELLATION Refund Of 75.00 Enrollee Name: Cameron Khan Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476003 -07 Outdoor Explorers 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01/14/2011 (Cancelled) Class Location: Meeting House Class Dates: 07/11/2011 to 07/15/2011 Meeting House 8 to 4:30P 1507 E, 116th Street M,Tu,W,Th,F Carmel, IN 46032 Scheduled Sessions: 5 (317)848 -7275 Cancel Reason: moving out of state CANCELLATION Refund Of 75.00 Enrollee Name: Cameron Khan Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476003 -08 Outdoor Explorers 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01/14/2011 (Cancelled) Page 1 ACTIVITY REFUND RECEIPT Receipt 618818 Payment Date: 05/19/2011 Household 3979 Class Location: Meeting House Class Dates: 07/18/2011 to 07/22/2011 Meeting House 8:30A to 4:30P 1507 E. 116th Street M,Tu,W,Th,F Carmel, IN 46032 Scheduled Sessions: 5 (317)848 -7275 Cancel Reason: moving out of state CANCELLATION Refund Of 60.00 Enrollee Name: Cameron Khan Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476009 -33 SSA (Track Field) 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01/14/2011 (Cancelled) Class Location: Creekside Middle Sch Class Dates: 06/27/2011 to 07/01/2011 Creekside Middle Sch 9:OOA to 12:OOP 3525 W. 126th Street M,Tu,W,Th,F Carmel, IN 46032 Scheduled Sessions: 5 (317)848 -7275 Cancel Reason: moving out of state CANCELLATION Refund Of 75.00 Enrollee Name: Keith Khan Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476003 -04 Outdoor Explorers 7.00 0.00 0.00 7.00 0.00 Enrollment Date: 01114/2011 (Cancelled) Class location: Meeting House Class Dates: 06/20/2011 to 06/24/2011 Meeting House 8:30A to 4:30P 1507 E. 116th Street M,Tu,W,Th,F Carmel, IN 46032 Scheduled Sessions: 5 (317)848 -7275 Cancel Reason: moving out of state CANCELLATION Refund Of 75.00 Enrollee Name: Keith Khan Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476003 -05 Outdoor Explorers 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01/1412011 (Cancelled) Class Location: Meeting House Class Dates: 06/27/2011 to 07/01/2011 Meeting House 8:30A to 4:30P 1507 E. 116th Street M,Tu,W,Th,F Carmel, IN 46032 Scheduled Sessions: 5 (317)848 -7275 Cancel Reason: moving out of state CANCELLATION Refund Of 60.00 Enrollee Name: Keith Khan Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476003 -06 Outdoor Explorers 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01/14/2011 (Cancelled) Page 2 ACTIVITY REFUND RECEIPT Receipt 618818 Payment Date: 05/19/2011 Household 3979 Class Location: Meeting House Class Dates: 07/05/2011 to 07/08/2011 Meeting House 8:30A to 4:30P 1507 E. 116th Street Tu,W,Th,F Carmel, IN 46032 Scheduled Sessions: 4 (317)848 -7275 Cancel Reason: moving out of state CANCELLATION Refund Of 75.00 Enrollee Name: Keith Khan Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476003 -07 Outdoor Explorers 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01/14/2011 (Cancelled) Class Location: Meeting House Class Dates: 07/11/2011 to 07/15/2011 Meeting House 8:30A to 4:30P 1507 E. 116th Street M,Tu,W,Th,F Carmel, IN 46032 Scheduled Sessions: 5 (317)848 -7275 Cancel Reason: moving out of state CANCELLATION Refund Of 75.00 Enrollee Name: Keith Khan Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476003 08 Outdoor Explorers 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01/14/2011 (Cancelled) Class Location: Meeting House Class Dates: 07/18/2011 to 07/22/2011 Meeting House 8:30A to 4:30P e 1507 E. 116th Street M,Tu,W,Th,F I,H Carmel, IN 46032 Scheduled Sessions: 5 uq� (317)848 -7275 Q 3 2011 Cancel Reason: moving out of state PREVIOUS NET HOUSEHOLD BALANCE 0.00 Processed on 05/19111 16:19:56 by BJJ FEES CHANGED ON CANCELLED ITEMS 705.00 f 0 SURCHARGE APPLIED AGAINST CANCELLED FEES 7.00 nQ NET AMOUNT FROM CANCELLED ITEMS $98:00- TOTAL AMOUNT REFUNDED 698.00 �O NEW NET HOUSEHOLD BALANCE 0.00 Refund of 698.00 Made By REFUND FINAN With Reference All refunds a 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. ll b�d u ed Signature Date Authorized Signature Date Page 3 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 Khan, Stephanie Date Due 3647 E Carmel Drive Carmel, IN 46033 Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 638.00 5119111 618818 Refund 60.00 5119111 618818 Refund Total 698.00 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. Khan, Stephanie Allowed 20 3647 E Carmel Drive Carmel, IN 46033 In Sum of 698.00 ON ACCOUNT OF APPROPRIATION FOR 108 ESE PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1082 -3 618818 4358400 638.00 i hereby certify that the attached invoice(s), or 1082 -98 618818 4358400 60.00 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 6 -Jun 2011 Signature 698.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund