165204 10/29/2008 CITY OF CARMEL, INDIANA VENDOR: T362043 Page 1 of 1
ONE CIVIC SQUARE ESTHER DORA
0 CHECK AMOUNT: $38.00
CARMEL, INDIANA 46032 5248 APACHE MOON
CARMEL IN 46033 CHECK NUMBER: 165204
CHECK DATE: 10/29/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 .196118 38.00 REFUNDS AWARDS TNDE
at
ACTIVITY REFUND RECEIPT
Receipt 196118
Payment Date: 10/20/2008 70C�T2 Household 20976 T�T�+-
Horne Phone: (317)833 -5175
Work Phone: 7008
BY:
ESTHER DORA Monon Center
5248 APACHE MOON Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 38.00
Enrollee Name: Connor Dora Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 286258 -02 Start Smart Soccer 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 08111/2008 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Gymnasium B Class Dates: 10/29/2008 to 12/10/2008
Monon Center 10:OOA to 11:OOA
W
Carmel, IN 46032 Skip Days 11/26/2008
(317)848 -7275 Scheduled Sessions: 6
Fee Details: Fee Descri Amount C ount Discount Sales Tax Total Fee
Start Smart Soccer 7.00 1.00 0.00 0.00 7.00
Cancel Reason: sitter for other child fell through
G/L Code Descriptio Acc ount Number Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 38.00 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 10/20/08 09:44:18 by CNA FEES CHANGED ON CANCELLED ITEMS 45.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 7.00
NET AMOUNT FROM CANCELLED ITEMS 38.00
TOTAL AMOUNT REFUNDED 38.00
NEW NET HOUSEHOLD BALANCE 0.00
Page 1
ACTIVITY REFUND RECEIPT
Receipt 196118
Payment Date: 10/20/2008
Household 20976
Refund of 38.00 Made By REFUND FINAN With Reference sitter fell through
Rewards Points refunded on this receipt: 0.70
Household Reward Point Balance: 0.70
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.
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Aut orized Signature Date Authorized Signature Date
Ln. 3 JG �Od y� J
I
OCT 2 2 7008
BY:
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.
Dora, Esther Terms
5248 Apache Moon Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/20/08 196118 Refund 38.00
Total 38.00
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.
Dora, Esther Allowed 20
5248 Apache Moon
Carmel, IN 46033
In Sum of
38.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 196118 4358400 38.00 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
22 -Oct 2008
�,�lC�1/)YI/J�701T/
Signature
38.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund