166206 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: T362179 Page 1 of 1
ONE CIVIC SQUARE MICHELE FOXWORTHY CHECK AMOUNT: $62.26
CARMEL, INDIANA 46032 13301 MOHICAN
CARMEL IN 46033 CHECK NUMBER: 166206
CHECK DATE: 11124/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION
1046 4358400 197387 62.26 REFUNDS AWARDS INDE
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ACTIVITY REFUND RECEIPT
Rec.ipt 197387
Payment Date: 10/28/2008 NOV 1 2 2008
Household 6299
Home Phone: (317)580 -1404
WoiR Phone: (317) By:
MICHELE FOXWORTHY Prairie Trace Elemen
13301 MOHICAN 14200 North River Road
CARMEL IN 46033 Carmel IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 48.00
Enrollee Name: Maddie FOXWorthy IT;� Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 486073 -02 Karate 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 10/13/2008 (Cancelled)
Class Location: Prairie Trace Elem Class Dates: 10/28/2008 to 11/20/2008
Prairie Trace Elemen 2:45P to 3:45P
14200 North River Road Tu,Th
Carmel, IN 46033
(317)848 -7275 Scheduled Sessions: 8
Cancel Reason: E2 class cancelled
G/L Code Descri Account Number Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 62.26 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 14.26
Processed on 10/28/08 13:24:59 by SLS FEES CHANGED ON CANCELLED ITEMS 48.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 48.00
HH BALANCE APPLIED TO THIS RECEIPT 14.26
TOTAL AMOUNT REFUNDED 62.26
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 62.26 Made By REFUND FINAN With Reference
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ACTIVITY REFUND RECEIPT
Receipt 197387
Payment Date: 10/28/2008
Household 6299
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.
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Authored Si at Date Authorized Signature Date
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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.
Foxworthy, Michele Terms
13301 Mohican Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/28/08 197387 Refund 62.26
Total 62.26
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.
Foxworthy, Michele Allowed 20
13301 Mohican
Carmel, IN 46033
In Sum of
62.26
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 197387 4358400 62.26 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
17 -Nov 2008
Signature
62.26 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund