164052 09/17/2008 *f CITY OF CARMEL, INDIANA VENDOR: T356224 Page 1 of 1
0 ONE CIVIC SQUARE JENNICA ZALEWSKI CHECK AMOUNT: $35.00
CARMEL, INDIANA 46032 4953 ST CHARLES PLACE
CARMEL IN 46033
CHECK NUMBER: 164052
CHECK DATE: 9/17/2008
DEPARTMENT ACCOUNT PO NUMB INVOICE. NUMBER AMOUNT DESCRIPTION
1047 4358400 182990 35.00 REFUNDS AWARDS INDE
4
ACTIVITY REFUND RECEIPT
Receipt 182990 SEP
Payment Date: 08/30/2008 2008
Household 21138
Home Phone: (317)848 -0036 BY
Work Phone: (317)417 -3031
JENNICA ZALEWSKI Monon Center
4953 ST. CHARLES PLACE Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 35.00
Enrollee Name: Julian Zalewski Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 286346 -01 Claytastic 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 08/14/2008 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Art Studio Class Dates: 09/04/2008 to 09/25/2008
Monon Center 4:OOP to 5:30P
Th
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 4
cancel Reason: low enrollment
G/L C ode Descri Account Num Cst Cntr Description _Acco Number A mount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 35.00 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 08/30/08 20:25:38 by CNA FEES CHANGED ON CANCELLED ITEMS 35.00-
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 35.00
TOTAL AMOUNT REFUNDED 35.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 35.00 Made By REFUND FINAN With Reference low enrollment
Page 1
1
ACTIVITY REFUND RECEIPT
Receipt 182990
Payment Date: 08/30/08
Household 21138
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.
644W G 0 q
Aut orized Signature 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 Purchase Order No.
Terms
Zalewski, Jennica
Date Due
4953 St Charles Place
Carmel, IN 46033
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) Amount
35.00
8/30/08 182990 Refund
Total 35.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Zalewski, Jennica Allowed 20
4953 St Charles Place
Carmel, IN 46033
In Sum of
35.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 182990 4358400 35.00 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
4 -Sep 2008
Signature
35.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund