161969 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 361625 Page 1 of 1
ONE CIVIC SQUARE ROSE NAKEEB CHECK AMOUNT: $300.00
CARMEL, INDIANA 46032 13135 BROOKS LANDING PLACE
CARMEL IN 46033
CHECK NUMBER: 161969
CHECK DATE: 7/23/2008
DEPARTME ACCOU PO NUMBER INVOICE NUM BER AMOUNT DESCRIPTION
104.6 4358400 300.00 REFUNDS AWARDS INDE
M
ACTIVITY REFUND RECEIPT
Receipt 153023
Payment Date: 07/15/2008
Household 910 w
Home Phone: (317)816 -0873
Work Phone: JUL 1 7 2008
Y
ROSE NAKEEB Monon Center
13135 BROOKS LANDING PLACE Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 150.00
Enrollee Name: Kayla Nakeeb Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476001 -07 Vacation Station 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 04/08/2008 (Cancelled)
Class Location: Cherry Tree Elem Sch Class Dates: 07/14/2008 to 07/18/2008
Cherry Tree Elemental 7:OOA to 6:OOP
13869 Hazel Dell Road M,Tu,W,Th,F
Carmel, IN 46033
(317)848 -7275 Scheduled Sessions: 5
cancel Reason: completely dissatisfied with the camp experience at cherry tree on day one
CANCELLATION Refund Of 150.00
Enrollee Name: Alexander Nakeeb Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476001 -07 Vacation Station 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 04/08/2008 (Cancelled)
Class Location: Cherry Tree Elem Sch Class Dates: 07/14/2008 to 07/18/2008
Cherry Tree Elementa 7:OOA to 6:OOP
13869 Hazel Dell Road M,Tu,W,Th,F
Carmel, IN 46033
(317)848 -7275 Scheduled Sessions: 5
Cancel Reason: completely dissatisfied with the camp experience at cherry tree on day one
G/L Code Description Account Number Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 300.00 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.
Page #1
y
y ACTIVITY REFUND RECEIPT
Receipt 153023
Payment Date: 07/15/08
Household 910
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/15/08 12:06:02 by BJJ FEES CHANGED ON CANCELLED ITEMS 300.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 300.00
TOTAL AMOUNT REFUNDED 300.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 300.00 Made By REFUND FINAN With Reference
All refu ds 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. ITq
Aut oriz ignature Date Authorized Signature Date
p q Y
30' 10
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.
Nakeeb, Rose Terms
13135 Brooks Landing Place Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7115108 153023 Refund 300.00
Total 300.00
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.
Nakeeb, Rose Allowed 20
13135 Brooks Landing Place
Carmel, IN 46033
In Sum of
300.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 153023 4358400 300.00 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
18 -Jul 2008
Signature
300.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund