162747 08/20/2008 CITY OF CARMEL, INDIANA VENDOR: 361697 Page 1 of 1
ONE CIVIC SQUARE MAUREEN GOEMAN
CARMEL, INDIANA 46032 13633 EGLIN DRIVE
CHECK AMOUNT: $18.75
CARMEL IN 46032 CHECK NUMBER: 162747
CHECK DATE: 8/20/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUM AMOUNT DESCRIPTION
1047 4358400 18.75 PARKS DEPARTMENT REFU
t
ACTIVITY REFUND RECEIPT
Receipt 172210
Payment Date: 08/08/2008
Household 16918 =BY:
Home Phone: (317)587 -0272
Work Phone:
c
MAUREEN GOEMAN Monon Center
13633 EGLIN DRIVE Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 18.75
Enrollee Name: Jubilee Goeman Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 186358 -02 Intro to Irish Dance 11.25 0.00 0.00 11.25 0.00
Enrollment Date: 07/02/2008 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Dance Studio Class Dates: 07/08/2008 to 08/26/2008
Monon Center 7:OOP to 7:45P
Tu
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 8
Fee Details: Fee Descri A mount C ount Discount _Sales Tax Total Fee
Intro to Irish Dance 11.25 1.00 0.00 0.00 11.25
Cancel Reason: cancelled to due to instructor health
G/L Code Description Account Number Cst_Cntr Description Account Number,-- __A_mount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 18.75 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 08/08/08 14:19:47 by BJC FEES CHANGED ON CANCELLED ITEMS 30.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 11.25
NET AMOUNT FROM CANCELLED ITEMS 18.75
TOTAL AMOUNT REFUNDED 18.75
r
NEW NET HOUSEHOLD BALANCE K 0.00
Page 1
ACTIVITY REFUND RECEIPT
Receipt 172210
Payment Date: 08/08/08
Household 16918
Refund of 18.75 Made By REFUND FINAN With Reference instructors health
i
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check w'll be
issuA No cash or credit card refunds.
If 9
A horize nature Date Authorized Signature Date
M C ec
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.
Goeman, Maureen Terms
13633 Eglin Drive Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/8/08 172210 Refund 18.75
Total 18.75
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.
Goeman, Maureen Allowed 20
13633 Eglin Drive
Carmel, IN 46032
In Sum of
18.75
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 172210 4358400 18.75 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
14 -Aug 2008
Signature
18.75 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund