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162094 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 361633 Page 1 of 1 ONE CIVIC SQUARE STEVEN WALLACE CHECK AMOUNT: $280.00 CARMEL, INDIANA 46032 1446 POLO CHASE COURT CARMEL IN 46032 CHECK NUMBER: 162094 CHECK DATE: 7/23/2008 DEPARTMENT A CCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1047 4358400. 280.00 PARKS DEPARTMENT REFU C�l� ACTIVITY REFUND RECEIPT Receipt 155128 Payment Date: 07/17/2008 77 Household 16268 Home Phone: (317)581 -9095 JUL 2 1 2008 W1 Phone: (317)580 -0995 BY: STEVEN WALLACE Monon Center 1446 POLO CHASE COURT Carmel IN 46032 CARMEL IN 46032 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Enrollment Details CANCELLATION Refund Of 280.00 Enrollee Name: Mitchell Wallace Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 185311 -04 Paintball 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 06/30/2008 (Cancelled) Primary Instructor: Manny Francia Class Location: Proving Paintball Class Dates: 07/21/2008 to 07/25/2008 Proving Paintball 10:OOA to 2:30P 4440 SR 47 M,Tu,W,Th,F Sheridan, IN 46069 Scheduled Sessions: 5 Cancel Reason: low enrollment G/L Code Descri Account Number Cst Cntr Descri Account Number Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 280.00 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 07/17/08 11:19:58 by BJC FEES CHANGED ON CANCELLED ITEMS 280.00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 NET AMOUNT FROM CANCELLED ITEMS 280.00- 1 TOTAL AMOUNT REFUNDED_ 280.00 NEW NET HOUSEHOLD BALANCE 0.00 Refund of 280.00 Made By REFUND FINAN With Reference low enrollment Page 1 ACTIVITY REFUND RECEIPT Receipt 155128 Payment Date: 07/17/08 Household 16268 a 411 refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be Issue No cash or credit card refunds. Authoi d Signatu Date Authorized Signature Date 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. Wallace, Steven Terms l 1446 Polo Chase Court Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 7/17/08 155128 Refund 280.00 Total 280.00 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 G 2 0 4 t CD 2 0 2 C: E S a f k o 0 2 E 0 O o 2 Z 2 E\ 9 k ƒ f E j -n 0 0 i CL t a m a 2 CL z -n p q 2 a a s ƒ f k ƒ E 0 E Q G R q e 2 cn k e j G E c: J J co m a e o E a& S CD q E 0 k CD ƒ R q S e 7 0