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157929 04/01/2008 CITY OF CARMEL, INDIANA VENDOR: T361072 Page 1 of 1 ONE CIVIC SQUARE KELLY FORAKER CARMEL, INDIANA 46032 406 SHOEMAKER DR CHECK AMOUNT: $20.00 CARMEL IN 46032 CHECK NUMBER: 157929 CHECK DATE: 41112008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1047 4358400 99468 20.00 REFUNDS AWARDS INDE i j f ACTIVITY REFUND RECEIPT i� '5ece ipt 99468 ayment Date: 03/11/2008 RE Household 14878 Home Phone: (317)810 -9363 Work Phone: (317)810 -9363 MAR 1 7 2008 By:- 3b a,,-vm KELLY FORAKER Carmel Clay Parks Recreation 406 SHOEMAKER DR. 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 20.00 Enrollee Name: Robby Foraker Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 386215 -02 Sporties for Shortie 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01/06/2008 (Cancelled) Primary Instructor: CCPR Staff Class Location: Gymnasium C Class Dates: 03/05/2008 to 03/26/2008 Monon Center 1:OOP to 1:45P W Carmel, IN 46032 (317)848 -7275 Scheduled Sessions: 4 Cancel Reason. anxiety In class G/L Code_ Description Accou N umber Cst Cntr Descri Account Numb Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 20.00 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 03/11/08 05:22:37 by BJC FEES CHANGED ON CANCELLED ITEMS 20.00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 NET AMOUNT FROM CANCELLED ITEMS 20.00 TOTAL AMOUNT REFUNDED 20:00 NEW NET HOUSEHOLD BALANCE 0.00 Refund Type: Refund from Finance Refund of 20.00 Made By JOURNAL -RF With Reference anxiety in class Page 1 ACTIVITY REFUND RECEIPT `t Receipt 99468 ,4 Payment Date: 03/11/08 Household 14878 All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 eks to process. A check will be issued. No cash or credit and refunds. -5 i AedKorized 91 �gri ate ature D Authorized Signature e H q �J�9 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. Kelly Foraker Terms 406 Shoemaker Dr. Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 3/11/08 99468 Refund 20.00 Total 20.00 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. Kelly Foraker Allowed 20 406 Shoemaker Dr. Carmel, IN 46032 In Sum of 20.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 99468 4358400 20.00 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 24 -Mar 2008 Sig tices e 20.00 Busin ss Manager Cost distribution ledger classification if Title claim paid motor vehicle highway fund