166215 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: T361992 Page 1 of 1
ONE CIVIC SQUARE NABIL GHALAYINI
CARMEL, INDIANA 46032 14401 CHARIOTS WHISPER DR CHECK AMOUNT: $58.00
WESTFIELD IN 46074 CHECK NUMBER: 166215
CHECK DATE: 11/24/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMO DESCRIPTION
1047 4358400 200800 58.00 'REFUNDS AWARDS INDE
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ACTIVITY REFUND RECEIPT
C.P'T �-D
Receipt# 200800 NOV 1 3 2008
Payment Date: 11/13/2008
Household 20975
Home Phone: (317)844 -8634 BY:
Work Phone: (317)
NABIL GHALAYINI Monon Center
14401 CHARIOTS WHISPER DR. Carmel IN 46032
WESTFIELD IN 46074
Phone: (317)848- 275
Fed Tax I D #35 -6 00972
Enrollment Details
CANCELLATION Refund Of 58.00
Enrollee Name: Danny Ghalayini Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 283005 -11 Polliwog -Level 1 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 08/26/2008 (Cancelled)
Class Location: Indoor Lap Pool 1 Class Dates: 11/17/2008 to 11/ 1/2008
Monon Center 6:OOP to 6:45P
M,W
Carmel, IN 46032 Skip Days 11/24/2008, 11/2E/2008
(317)848 -7275 Scheduled Sessions: 2
Fee Details: Fee Description Amount Count Discount S les Tax Total Fee
Polliwog 7.00 1.00 0.00 0.00 7.00
Cancel Reason: Parnet changed mind.
GIL Code Desc Account Number Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 58.00 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 11/13/08 10:46:43 by ALC FEES CHANGED ON CANCELLED ITEMS 65.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 7.00
NET AMOUN:T,zF OM CANCELLED ITEMS 58:00
TOTAL `AMOUNT REFUNDED %58.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 58.00 Made By REFUND FINAN With Reference
Page 1
ACTIVITY REFUND RECEIPT
Receipt 200800
Payment Date: 11/13/2008
Household 20975
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
i sued. No cash or redit card refunds.
i
Authorized Sign a bate Authorized Signature Date
Page 2
ACCOUNTS PAYABLE VOUCHER
`t CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates servi e rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Ghalayini, Nabil Terms
14401 Chariots Whisper Dr Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/13/08 200800 Refund 58.00
Total 58.00
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in aci ordance
with IC 5- 11- 10 -1.6
20_
Clerk- Treasurer
Voucher No. Warrant No.
Ghalayini, Nabil Allowed 20
14401 Chariots Whisper Dr
Westfield, IN 46074
In Sum of
C�-
58.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #TrITLE AMOUNT Board Members
Dept
1047 200800 4358400 58.00 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
19 -Nov 2008
Signature
i s 58.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
4
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