158005 04/01/2008 CITY OF CARMEL, INDIANA VENDOR: T361075 Page 1 of 1
ONE CIVIC SQUARE MARIAM KHANI CHECK AMOUNT: $300.00
CARMEL, INDIANA 46032 4078 WILD WOOD Cr
7_IONSVILLE IN 46077
CHECK NUMBER: 158005
CHECK DATE: 4/1/2008
DEPARTMENT ACCOUNT PO NU MBE R I NVOICE NUMBE AMOUNT DES
1046 4358400 102351 300.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
a RECEIVED
Receipt# 102351
Payment Date: 03/25/2008
Household 16347 MAR 2 5 2008
Home Phone: (317)733 -0786 r I r
Work Phone: (317) BY: f GWWj
MARIAM KHAN Monon Center
4078 WILD WOOD CT Carmel IN 46032
ZIONSVILLE, IN 46077
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 150.00
Enrollee Name: Mustafa Khan Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476001 -32 Vacation Station 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 02/28/2008 (Cancelled)
Class Location: College Wood Elem Class Dates: 06/09/2008 to 06/13/2008
College Wood Element 7:OOA to 6:OOP
12415 Shelbourne Road M,Tu,W,Th,F
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 5
Cancel Reason: change in summer schedule
CANCELLATION Refund Of 150.00
Enrollee Name: Mustafa Khan Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476001 -39 Vacation Station 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 02/28/2008 (Cancelled)
Class Location: College Wood Elem Class Dates: 07/28/2008 to 08/01/2008
College Wood Element 7:OOA to 6-OOP
12415 Shelbourne Road M,Tu,W,Th,F
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 5
Cancel Reason: change in summer schedule
G/L Code Description Account Number Cst Cntr Descri Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 300.00 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.
Page 1
ACTIVITY REFUND RECEIPT
1 Receipt 102351
Payment Date: 03/25/08
Household 16347
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 03/25/08 09:47:19 by BJJ FEES CHANGED ON CANCELLED ITEMS 300.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0 -00
SALES TAX CHARGED ON CANCELLED FEES 0.00
li! NET AMOUNT 3 FROMYCANCELLED-ITEMS" w >300 UOt_'
'�,"-,T,OTAL, AMOUNT;REFUNDED
NEW NET HOUSEHOLD BALANCE 0.00
Refund Type: Refund from Finance
Refund of 300.00 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. No cash or credit car ds.
6s`0
thor' d Signature Date Authorized Signature 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.
Mariam Khani Terms
4078 Wild Wood Ct. Date Due
l Zionsville, IN 46077
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/25/08 102351 Refund 300.00
Total 300.00
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
Vouc; No. Warrant No.
Mariam Khani Allowed 20
4078 Wild Wood Ct.
Zionsville, IN 46077
In Sum of$
300.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #1TITLE AMOUNT Board Members
Dept
1046 102351 4358400 300.00 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
i
300.00 Busi 4 ess Se ces Manager
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund