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155937 01/23/2008 CITY OF CARMEL, INDIANA VENDOR: T360729 Page 1 of 1 ONE CIVIC SQUARE YVETTE VAN DER WIEL CARMEL, INDIANA 46032 9660 SUMMERLAKES DR CHECK AMOUNT: $50.00 CARMEL IN 46032 CHECK NUMBER: 155937 CHECK DATE: 1/2312008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1047 4358400 82127 50.00 REFUNDS AWARDS INDE ACTIVITY REFUND RECEIPT !cdipt 82127 yr Date: 01/07/2008 useh;old 14628 =Y me`tPhone: (317)582 -0666 i )rk Phone: (317) JAN p YVETTE VAN DER WIEL Monon Center 9660 SUMMERLAKES DR Carmel IN 46032 CARMEL, IN 46032 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 irollment Details CANCELLATION Refund Of 50.00 Enrollee Name: Brooke Van der Wiel Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 388033 -01 Volleyball 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01/02/2008 (Cancelled) Primary Instructor: CCPR Staff Class Location: Gymnasium C Class Dates: 01/07/2008 to 02/25/2008 Monon Center 4:30P to 5:30P M Carmel, IN 46032 Skip Days 01/21/2008, 02/18/2008 (317)848 -7275 Scheduled Sessions: 6 Cancel Reason: low enrollment G/L Code De Acc ount Number Cst Cntr Descri Account Number Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 50.00 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 01/07/08 11:36:25 by TCP FEES CHANGED ON CANCELLED ITEMS 50:00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 ;NET AMOUNT FROM CANCELLED ITEMS 50.00 TOTAL AMOUNT REFUNDED 50:00 NEW NET HOUSEHOLD BALANCE 0.00 Refund Type: Refund from Finance Refund of 50.00 Made By JOURNAL -RF With Reference low enrollment Page 1 ACTIVITY REFUND RECEIPT Receipt 82127 Payment Date: 01/07/08 Household 14628 All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 eks to process. A check will be issued. No cash or credit card refunds. Authorized Signature Date A thorized ig tare ate 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. Yvette Van der Wiel Terms 9660 Summerlakes Dr. Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 1/7/08 82127 Refund 50.00 Total 50.00 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. Yvette Van der Wiel Allowed 20 9660 Summerlakes Dr. Carmel, IN 46032 In Sum of 50.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 82127 4358400 50.00 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 16 -Jan 2008 igVe$ 50.00 Business a Mana er Cost distribution ledger classification if Title claim paid motor vehicle highway fund