169896 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: T362669 Page 1 of 1
ONE CIVIC SQUARE FACEY BLAKE CHECK AMOUNT: $58.00
CARMEL, INDIANA 46032 10308 CENTRAL AVE
INDIANAPOLIS IN 46280 CHECK NUMBER: 169896
CHECK DATE: 3/18/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 58.00 PARKS DEPARTMENT REFU
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ACTIVITY REFUND RECEIPT
Receipt 236208
Payment Date: 03/08/2009
Household 1852 MAR 1 2 2009
Home Phone: (317)846 -4364
Work Phone: (317)805 -4376 r.
BLAKE FACEY Monon Center
10308 CENTRAL AVE. Carmel IN 46032
INDIANAPOLIS IN 46280
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 58.00
Enrollee Name: Elijah Facey Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 393002 -06 Splashin' Tot 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 12/01/2008 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Indr Leisure Pool 2 Class Dates: 02/23/2009 to 03/25/2009
Monon Center 5:15P to 5:45P
M,W
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 10
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Splashin' Tot 7.00 1.00 0.00 0.00 7.00
Cancel Reason: schedule conflict
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 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 03/08/09 12:50:56 by ALC FEES CHANGED ON CANCELLED ITEMS 65.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
o-c 0 SURCHARGE APPLIED AGAINST CANCELLED FEES 7.00
l w�t�l w` "O� rNET AMOUNT FROM.CANCELLED ITEMS 58:00
°'TOTAL AMOUN;TkREFUNDED ,,O ,,58:00
NEW NET HOUSEHOLD BALANCE 0.00
Page 1
ACTIVITY REFUND RECEIPT
Receipt 236208
Payment Date: 03/08/2009
Household 1852
Refund of 58.00 Made By REFUND FINAN With Reference
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. No cash or credit card refunds.
Authorized Signature Date Authorized Signature Date
Page 2
I
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.
Facey, Blake Terms
10308 Central Ave Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/8/09 236208 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 accordance
with IC 5- 11- 10 -1.6
,20
Clerk- Treasurer
Voucher No. Warrant No.
Facey, Blake Allowed 20
10308 Central Ave
Indianapolis, IN 46280
In Sum of$
58.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 236208 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
12 -Mar 2009
Signature
I 58.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund