162840 08/20/2008 CITY OF CARMEL, INDIANA VENDOR: T361698 Page 1 of 1
p ONE CIVEC SQUARE BECCA LANTZ
1 CARMEL, INDIANA 46032 1820 FRANKLIN BLVD CHECK AMOUNT: $15.00
CARMEL IN 45032 CHECK NUMBER: 162840
CHECK DATE: 8/20/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 15.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt 170136 R CEIVED
Payment Date: 08/06/2008
Household 19965 qUG 0 7
Home Phone: (317)460 -6995 ��08
Work Phone:
BECCA LANTZ Monon Center
1820 FRANKLIN BLVD Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 15.00
Enrollee Name: Gabrielle Lantz Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number 186358 02 Intro to Irish Dance 15.00 0.00 0.00 15.00 0.00
Enrollment Date: 06/30/2008 (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: F Description Am Co Discount Sales-Tax _Total Fee
Intro to Irish Dance 15.00 1.00 0.00 0.00 15.00
Cancel Reason: instructor health problems
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 15.00 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 08106/08 11;46:19 by BJC FEES CHANGED ON CANCELLED 7EMS 30.00
DISCOUNT APPLIED AGAINST CANCELLED FEES O 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 15.00
NET AMOUNT FROM CANCELLED ITEMS Y5.00-
TOTAL AMOUNT REFUNDED 7 15.00
NEW NET HOUSEHOLD BALANCE 0.00
Page 1
ACTIVITY REFUND RECEIPT
Receipt 170136
Payment Date: 08/06/08
Household 19965
Refund of 15.00 Made By REFUND FINAN With Reference instructor health
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 r nds.
LIP
Authorized Signature Date Authorized Signature Date
q3_ AoD
VED
I
AUG 0 7 2008
BY:
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.
Lantz, Becca Terms
1820 Franklin Blvd Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
816108 170136 Refund 15.00
Total 15.00
I 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.
Lantz, Becca Allowed 20
1820 Franklin Blvd
Carmel, IN 46032
In Sum of
15.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT XTITLE AMOUNT Board Members
Dept
1047 170136 4358400 15.00 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
14 -Aug 2008
Signature
15.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund