159456 05/14/2008 CITY OF CARMEL, INDIANA VENDOR: T361260 Page 1 of 1
ONE CIVIC SQUARE CHEN LIN
CARMEL, INDIANA 46032 4051 TEAGUE PLACE CHECK AMOUNT: $182.00
WESTFIELD IN 46074 CHECK NUMBER: 159456
CHECK DATE: 5/14/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 182.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
,i
Receipt 112557
Payment Date: 05/02/2008
Household 17164
Home Phone: (317)733 -8327
Work Phone:
CHEN LIN Carmel Clay Parks Recreation
4051 TEAGUE PLACE 1235 Central Park Drive East
WESTFIELD IN 46074 Carmel IN 46032
Phone: (317)848-7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 84.00
Enrollee Name: Chen Lin Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 187365 -01 Salsa 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 04/06/2008 (Cancelled)
Primary Instructor: Rob Jenkins
Class Location: Dance Class Studio Class Dates: 05/02/2008 to 06/20/2008
Dance Class Studio 7:30P to 8:30P
260 W. Carmel Drive F
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 8
Fee Details: Fee Descr Amount Count Discount Sales Tax Total Fee
salsa 7.00 1.00 0.00 0.00 7.00
Cancel Reason: Business Trip
CANCELLATION Refund Of 98.00
Enrollee Name: Lucy Yang Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 187365 -01 Salsa 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 04/0612008 (Cancelled)
Primary Instructor: Rob Jenkins
Class Location: Dance Class Studio Class Dates: 05/02/2008 to 06/20/2008
Dance Class Studio 7:30P to 8:30P
260 W. Carmel Drive F
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 8
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
salsa 7.00 1.00 0.00 0.00 7.00
Cancel Reason: Will be out of town during program period
MAY 0 2008
Bx:
Page 1
ACTIVITY REFUND RECEIPT
Receipt 112557
Payment Date: 05/02/08
Household 17164
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 182.00 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 05/02/08 08:07:10 by LVA FEES CHANGED ON CANCELLED ITEMS 196.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 14.00
NET AMOUNT FROM CANCELLED ITEMS 182.00
TOTAL AMOUNT REFUNDED 182.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 182.00 Made By JOURNAL -RF With Reference
All refunds are subject to State Board of Accounts claim procedure and may t e 4 -6 ks to rocess. A check will be
issue.. No cash or credit card refunds.
Authorized Signature Date Authoriz A i ature Date
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.
Lin, Chen Terms
4051 Teague Place Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/2/08 112557 Refund 182.00
Total 182.00
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
Von -sner No. Warrant No.
Lin, Chen Allowed 20
4051 Teague Place
Westfield, IN 46074 (1 OL�
In Sum of
182.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 112557 4358400 182.00 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 -May 2008
ign ure
182.00 Business ervi es Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund