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Home My WebLink About156896 02/21/2008 CITY OF CARMEL, INDIANA VENDOR: T357229 Page 1 of 1 ONE CIVIC SQUARE DENISE COMMBELLICK O ti ,ra' CARMEL, INDIANA 46032 14316 JES$I LANE CHECK AMOUNT: $160.00 CARMEL IN 46033 CHECK NUMBER: 156896 CHECK DATE: 2/2112008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1047 4338400 160.00 PARKS DEPARTMENT REFU ACTIVITY REFUND RECEIPT Receipt 90622 RECEDED Payment Date: 02/05/2008 Household 813 FEB 1 5 2008 Home Phone: (317)843 -9807 Work Phone: (317)523 -4431 BY: DENISE COM13ELLICK Monon Center d 14316 JESSI LANE Carmel IN 46032 CARMEL, IN 46033 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Enrollment Details CANCELLATION Refund Of 80.00 Enrollee Name: Catelyn Combellick Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 386229 -05 Intro To Dance 4 -5 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 12/1812007 (Cancelled) Primary Instructor: Dance Class Studio Class Location: Dance /Fitness Room Class Dates: 03/11/2008 to 04/29/2008 Monon Center 12:30P to 1:30P Tu Carmel, IN 46032 (317)848 -7275 Scheduled Sessions: 8 Cancel Reason: unable to attend CANCELLATION Refund Of 80.00 Enrollee Name: Cydney Combelllck Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 386229 -05 Intro To Dance 4 -5 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 12/18/2007 (Cancelled) Primary Instructor: Dance Class Studio Class Location: Dance /Fitness Room Class Dates: 03/11/2008 to 04/29/2008 Monon Center 12:30P to 1:30P Tu Carmel, IN 46032 (317)848 -7275 Scheduled Sessions: 8 Cancel Reason: unable to attend 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 160.00 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 ACTIVITY REFUND RECEIPT Receipt 90622 Payment Date: 02/05/08 Household 813 PREVIOUS NET HOUSEHOLD BALANCE 0.00 t Processed on 02/05108 15:02:50 by TCP FEES CHANGED ON CANCELLED ITEMS 160.00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 I. ,NET- 'AMOUNT'FF2oM. 760 OQ hTOTAL "AMOUNT4REFUNOED r7 NEW NET HOUSEHOLD BALANCE 0.00 Refund Type: Refund from Finance Refund of 160.00 Made By JOURNAL -RF With Reference unable to attend All refunds are subject to State Board of Accounts claim procedure and may take weeks to process. A check will be issued. No cash or credit card refunds. Authorized Signature Date Authorized Sig ature Date LA 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. Denise Combellick Terms 14316 Jessi Lane Date Due Carmel, IN 46033 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 2/5/08 90622 Refund 160.00 Total 160.00 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. Denise Combellick Allowed 20 14316 Jessi Lane Carmel, IN 46033 In Sum of 160.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 90622 4358400 160.00 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 -Feb 2008 Sigr4dture 160.00 Business Services Manager Cost distribution ledger classification if Title claim paid motor vehicle highway fund