163809 09/17/2008 CITY OF CARMEL, INDIANA VENDOR: T361818 Page 1 of 1
ONE CIVIC SQUARE JENNIFER DESORMIERS CHECK AMOUNT: $65.00
CARMEL, INDIANA 46032 5964 KIRKENDALL CT
CARMEL IN 46033 CHECK NUMBER: 163809
CHECK DATE: 9/1712008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT D
1047 4358400 181511 65.00 REFUNDS AWARDS INDE
r
ACTIVITY REFUND RECEIPT
Receipt 181511
Payment Date: 08/28/2008 Household 2915 Home Phone: (317)844 -4521 Work Phone:
JENNIFER DESORMIERS Monon Center
5964 KIRKENDALL CT. Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 65.00
Enrollee Name: Caroline Desormiers Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 283005 -02 Polliwog -Level 1 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 08/02/2008 (Cancelled)
Class Location: Indoor Lap Pool 1 Class Dates: 09/06/2008 to 11/08/2008
Monon Center 10:OOA to 10:45A
Sa
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 10
Cancel Reason: Personal conflict AC
G/L Code Description Account Number Cst Cntr Description Account Number Amount
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 08/28/08 10:16:49 by ALC FEES CHANGED ON CANCELLED ITEMS 65.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NETAMOUNT'FROM CANCELLED 'ITEMS .65:00
TOTAL`AMOUNTREFUNDED 65;00',.
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 181511
Payment Date: 08/28/08
Household 2915
2
Authorzed Sign toe Date Authorized Signature Date
b0
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.
Desormiers, Jennifer Terms
5964 Kirkendall Ct. Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s))
Amount
8/28/08 181511 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.
Desormiers, Jennifer Allowed 20
5964 Kirkendall Ct.
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 181511 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
3 -Sep 2008
Signature
65.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund