164207 09/30/2008 CITY OF CARMEL, INDIANA VENDOR: T361897 Page 1 of 1
ONE CIVIC SQUARE SOHAILIA DELDAR
CARMEL, INDIANA 46032 13872 FElNLEAF WAY CHECK AMOUNT: $65.00
CARMEL IN 46033 CHECK NUMBER: 164207
CHECK DATE: 9/30/200B
DEPARTMEN ACCOUNT P O NUMBER I NVOICE NUMBER AMOUNT DESC
1047 4356400 65::00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Recel-pt 186213
Payment Date: 09/08/2008
Household 11314 R CF1T'V%TF'D1
Home Phone: (317)566 -8667
Work Phone: (317)208 -0000 SEP 16 2008
BY:
SOHAILIA DELDAR Monon Center
;t 13872 FEINLEAF WAY Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 65.00
Enrollee Name: Ryan Deldar Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 283003 -03 Guppy 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 08/0612008 (Cancelled)
Class Location: Indoor Lap Pool 3 Class Dates: 09/06/2008 to 11/08/2008
Monon Center 10:30A to 11:00A
Sa
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 10
Cancel Reason: parent changed mind
G/L C ode Description Account Number Cst Cntr Description Account Number 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 09/08/08 11:35:17 by ALC FEES CHANGED ON CANCELLED ITEMS 65.00
DISCOUNT APPLIED AGAINST CANCELLED FEES O 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET :AMOUN,TvFROM:CANCELLED'ITEMS. 65 €00 =`n
;TOTAL`AMOUNTREFUNDED z,. 5 .F
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 65.00 Made By REFUND FINAN With Reference
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.
Page 1
ACTIVITY REFUND RECEIPT
Receipt 186213
Payment Date: 09/08/08
Household 11314
D
i
Authorized Signature Date Authorized Signature Date
o
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.
Deldar, Sohailia Terms
13872 Feinleaf Way Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/8/08 186213 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.
Deldar, Sohailia Allowed 20
13872 Feinleaf Way
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 186213 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 -Sep 2008
Signature
65.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund