155264 01/10/2008 CITY OF CARMEL, INDIANA VENDOR: T357741 Page 1 of 1
ONE CIVIC SQUARE KRISPEN CULPEPPER
CHECK AMOUNT: $60.00
t`•,`� CARMEL, INDIANA 46032 14022 STAGHORN DRIVE
CARMEL IN 45032 CHECK NUMBER: 155264
CHECK DATE: 1/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 75799 60.0.0 REFUNDS AWARDS INDE
i
ACTIVITY REFUND RECEIPT
Receipt 75799
Payment Date: 12/10/2007 C 1 2n Household 4406
Home Phone: (317)818 -9035
Work Phone: (317)571 -4084
c
KRISPEN CULPEPPER Carmel Clay Parks Recreation
14022 STAGHORN DRIVE 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 10.00
Enrollee Name: Morgan Culpepper Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 276330 -04 Parent's Night Out 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 10/02/2007 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Program Rms A, B, C Class Dates: 12/14/2007 to 12/14/2007
Monon Center 6:OOP to 10:OOP
F
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 1
Cancel Reason: low enrollment
CANCELLATION Refund Of 10.00
Enrollee Name: Meridian Culpepper Fees +Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 276330 -04 Parent's Night Out 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 1010212007 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Program Rms A, B, C Class Dates. 12/14/2007 to 12/14/2007
Monon Center 6:OOP to 1O:OOP
F
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 1
cancel Reason: low enrollment
CANCELLATION Refund Of 10.00
Enrollee Name: Will Culpepper Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 276330 -04 Parent's Night Out 0.00 0.00 0.00 0.00 0.00
Enrollment Date. 10/11/2007 (Cancelled)
Page 1
ACTIVITY REFUND RECEIPT
Receipt 75799
Payment Date: 12/10/07
Household 4406
Primary Instructor: CCPR Staff
Class Location: Program Rms A, B, C Class Dates: 12/14/2007 to 12/14/2007
Monon Center 6:OOP to 10:OOP
F
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 1
Cancel Reason: low enrollment
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 30.00 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 CREDIT HOUSEHOLD BALANCE 30.00
Processed on 12/10/07 10:13:33 by BJC FEES CHANGED ON CANCELLED ITEMS 30.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 30.00
HH BALANCE APPLIED TO THIS RECEIPT 30.00
TOTAL AMOUNT REFUNDED 60.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund Type: Refund from Finance
Refund of 60.00 Made By JOURNAL -RF With Reference low enrollment/HHC
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
iss cas credit card refunds.
Autt ¢ed Signature ate Authonzed Sg tur DJte
L 3 Do �s �-qoa
CAD
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.
Krispen Culpepper Terms
14022 Staghorn Drive Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/10/07 75799 Refund 60.00
Total 60.00
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.
Krispen Culpepper Allowed 20
14022 Staghorn Drive
Carmel, IN -46032
In Sum of
60.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 75799 4358400_ 60.00 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 -Jan 2008
Signature
60.00 Business Servic Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund