159434 05/14/2008 CITY OF CARMEL, INDIANA VENDOR: T361256 Page 1 of 1
ONE CIVIC SQUARE AKMAL KHAN
„o CARMEL, INDIANA 46032 13146 PENNEAGLE DRIVE CHECK AMOUNT: $1,240.00
w rod `o CARMEL IN 46033 CHECK NUMBER: 159434
CHECK DATE: 511412008
DEPARTMENT ACCOUNT PO N INVOICE NUMB AMOUNT DESCRIPTION
1046 4358400 1,200.00 REFUNDS AWARDS INDE
c
ACTIVITY REFUND RECEIPT
Receipt 102617
Payment Date: 03/26/2008
Household 8752
Home Phone: (317)566 -9118
Work Phone:
AKMAL KHAN Carmel Clay Parks Recreation
13146 PENNEAGLE DR. 1235 Central Park Drive Ea t
CARMEL, IN 46033 Carmel IN 46032 RC
Phone: (317)848 -7275
Fed Tax ID #35- 6000972 MAY 0 8 200$
Enrollment Details
ROSTER CHANGE
Enrollee Name: Kainat Akmal Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476008 -01 I.M.P.A.C.T. 250.00 0.00 250.00 0.00 0.00
Enrollment Date: 02/15/2008 (Enrolled)
Class Location: Carmel Clay Parks Of Class Dates: 06/02/2008 to 08/01/2008
CCPR Office 7:OOA to 6:OOP
760 Third Ave. SW Suite 100 M,Tu,W,Th,F
Carmel, IN 46032 Skip Days 07/04/2007
(317)848 -7275 Scheduled Sessions: 45
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
I.M.P.A.C.T, 250.00 1.00 0.00 0.00 250.00
Special Questions: Child's T -Shirt Size
Child's Swimming Level Int
ROSTER CHANGE
Enrollee Name: Hina Akmal Fees Tax Discount _Prev Paid T Cur Paid Amount DW e
Activity Number: 476008 -01 I.M.P.A.C.T. 250.00 0.00 250.00 0.00 0.00
Enrollment Date: 02/1512008 (Enrolled)
Class Location: Carmel Clay Parks Of Class Dates: 06/02/2008 to 08/01/2008
CCPR Office 7:OOA to 6:OOP
760 Third Ave. SW Suite 100 M,Tu,W,Th,F
Carmel, IN 46032 Skip Days 07/04/2007
(317)848 -7275 Scheduled Sessions: 45
Fee Details: Fee Description Amount Count Discount _Sales Tax Total Fee
I.M.P.A.C.T. 250.00 1.00 0.00 0.00 250.00
Special Questions: Child's T -Shirt Size AL
Child's Swimming Level Beg
Page 1
ACTIVITY REFUND RECEIPT
Receipt 102617
Payment Date: 03126/08
Household 8752
ROSTER CHANGE Refund Of 600.00
Enrollee Name: AwaiS Khan Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476006 -10 Science of Summer 525.00 0.00 525.00 0.00 0.00
Enrollment Date: 0211512008 (Enrolled)
Class Location: Orchard Park Elem Class Dates: 06/02/2008 to 08101(2008
Orchard Park Element 8:30A to 3:30P
10404 Orchard Park Drive South M,Tu,W,Th,F
Indianapolis, IN 46280
'(317)848 -7275 Scheduled Sessions: 45
Fee Details: Fee Descri Amo unt Count Discount Sales Tax T ota l F ee_
Science of Summer Re 525.00 1.00 0.00 0.00 525.00
Special Questions: Child's T -Shirt Size YS
Child's Swimming Level Beg
ROSTER CHANGE Refund Of 600.00
Enrollee Name: Mohammad Khan Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476006 -10 Science of Summer 525.00 0.00 525.00 0.00 0.00
Enrollment Date: 02/15/2008 (Enrolled)
Class Location: Orchard Park Elem Class Dates: 06/0212008 to 08/01/2008
Orchard Park Element 8:30A to 3:30P
10404 Orchard Park Drive South M,Tu,W,Th,F
Indianapolis, IN 46280
(317)848 -7275 Scheduled Sessions: 45
Fee Details: Fee De-scription Amount Count, Discount Sales T ax Total Fee
Science of Summer Re 525.00 1.00 0.00 0.00 525.00
Special Questions: Child's T -Shirt Size YS
Child's Swimming Level Beg
GIL Code Descri Account Number Cst_C_ntr_ Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 1200.00 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 500.00
Processed on 03/26/08 11:01:31 by LAA FEES ADJUSTED ON CHANGED ITEMS 1,700.00
DISCOUNT APPLIED AGAINST THESE FEES O 0.00
SALES TAX CHARGED ON CHANGED FEES 0.00
NET AMOUNT FROM CHANGED ITEMS 1 700A0-
HH BALANCE APPLIED TO THIS RECEIPT( 500.00
Page## 2
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r
ACTIVITY REFUND RECEIPT
Receipt 102617
Payment Date: 03/26/08
Household 8752
TOTAL AMOUNT REFUNDED 1 200.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund Type: Refund from Finance
Refund of 1,200.00 Made By JOURNAL -RF 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. o cash or credit card refunds. S2
thor' Signature Date Authorized Signature Date
1 r��
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Page 4 3
ACCOUNTS PAYABLE VOUCHER
tv 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.
Khan, Akmal Terms
13146 Penneagle Dr. Date Due
Carmel, IN 46033
Invoice EInvoice Description
Date er (or note attached invoice(s) or bill(s))
Amount
3/26/08 17 ;lRefund 1,200.00
Total 1,200.00
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.
Khan, Akmal Allowed 20
13146 Penneagle Dr.
Carmel, IN 46033�'�
In Sum of
1,200.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#/TITLE AMOUNT. Board Members
Dept
1046 102617 4358400 1,200.00 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
ao� F
Signature
1,200.00 Business Service Jnager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund