161222 07/08/2008 CITY OF CARMEL, INDIANA VENDOR: T361499 Page 1 of 1
ONE CIVIC SQUARE LISA MENDOZA CHECK AMOUNT: $35.00
CARMEL, INDIANA 46032 2810 CIRCLE CT
CARMEL IN 46032
CHECK NUMBER: 161222
CHECK DATE: 718/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 141465 35.00 REFUNDS AWARDS INDE
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I
ACTIVITY REFUND RECEIPT
Receipt 141465
Payment Date: 06/30/2008
Household 19193
Home Phone: (317)308 -7818
Work Phone: (847)219 -2647
LISA MENDOZA Carmel Clay Parks Recreation
2810 CIRCLE COURT 1235 Central Park Drive East
CARMEL IN 46032 Carmel IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 35.00
Enrollee Name: Lisa Mendoza Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 189002 -01 Family Campout 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 06/10/2008 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: West Park Shelter Class Dates: 06/13/2008 to 06/14/2008
West Park 4:30P to 9:OOA
2700 W. 116th St. F,Sa
Carmel, IN 46032
(317)848 7275 Scheduled Sessions: 2
Cancel Reason: unable to attend rain date
G/L Code Descri Account Number Cst Cntr Description Account Number Amount
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 06/30/08 11:48:35 by DMM 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
TOTAL AMOUNT AMOUNT REFUNDED 35.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 35.00 Made By JOURNAL -RF With Reference unable to attend
JUL 0 2 2008
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Page 1
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ACTIVITY REFUND RECEIPT
Receipt 141465
Payment Date: 06/30/08
Household 19193
All refunds are subject to State Board of Accounts claim procedure and, y t ke 4 -6 ks to process. A check will be
issued. No cash or credit card refunds.
Autho ¢ed Signature Date Authorized Signatu ate
9 7 3 5.3oo- q*3S7y
JUL 0 2 2008
BY
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
Mendoza, Lisa
Date Due
2810 Circle Court
Carmel, IN 46032
Invoice Invoice scription
Date Number
joiji d invoices) or bill(s)) Amount
35.00
6/30/08 141465 Refund
Total 35.00
I 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
Warrant No.
Voucher No. ^yir.
5:
Mendoza, Lisa Allowed
2810 Circle Court
3 r
Carmel, IN 46032
In Sum of
35.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
z '011
Board Members
PO# or INVOICE NO. ACCT #//TITLE AMOUNT
Dept
1047 141465 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 >4
received except
2 -Jul 2008'
Signature
35.00 Accounts Payable Coordinator
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
ENTERED
t