156189 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: T362177 Page 1 of 1
ONE CIVIC SQUARE CHRISTI EGGLESTON
CARMEL, INDIANA 46032 1334 EAST BEACON WAY CHECK AMOUNT: $63.00
CARMEL IN 46032 CHECK NUMBER: 166189
CHECK DATE: 11/24/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
-1047 4358400 199208 63.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 199208
Payment Date: 11/04/2008 N0V 1 2 20p8 ij
Household 10585
Home Phone: (317)705 -1856 f ",y- i
Work Phone:
CHRISTI EGGLESTON Monon Center
1334 EAST BEACON WAY Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 63.00
Enrollee Name: Shea Eggleston Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 286271 -02 Zumba for Kids 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 08/22/2008 (Cancelled)
Primary Instructor: Tumble Time
Class Location: Fitness Studio A Class Dates: 11/06/2008 to 12/18/2008
Monon Center 5:00P to 5:45P
Th
Carmel, IN 46032 Skip Days 11/27/2008
(317)848 -7275 Scheduled Sessions: 6
Cancel Reason: low enrollment
G1L C Description Acco Number Cs Cntr Descri Ac count Number Amo unt
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 6100 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 11(04108 17:53:40 by LVA FEES CHANGED ON CANCELLED ITEMS 63.00
DISCOUNT APPLIED AGAINST CANCELLED FEES (j 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 63.00
TOTAL AMOUNT REFUNDED 63.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 63.00 Made By REFUND FINAN With Reference low enrollment
Page 1
ACTIVITY REFUND RECEIPT
Receipt 199208
Payment Date: 11/04/2008
Household 10585
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued o cash or credit card refunds.
Authorized Si ure Date Authorized Signature Date
q 7 31oO. -S00. 0 3T q'00
z o I/vAa I61
LZ UJ -bl (oI
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
e
Purchase Order No.
Eggleston, Christi Terms
1334 East Beacon Way Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11!4!08 199208 Refund 63.00
Total 63.00
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.
Eggleston, Christi Allowed 20
1334 East Beacon Way
1 Carmel, IN 46032
In Sum of
63.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#rTITLE AMOUNT Board Members
Dept
1047 199208 4358400 63.00 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
17 -Nov 2008
Signature
63.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund