163605 09/17/2008 CITY OF CARMEL, INDIANA VENDOR: T361822 Page 1 of 1
ONE CIVIC SQUARE AMANDA KALLNER
CARMEL, INDIANA 46032 17751 VILLAGE BROOKE DR EAST CHECK AMOUNT: $71.75
NOBLESVILLE IN 46062 CHECK NUMBER: 163605
CHECK DATE: 9/17/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 185361 71.75 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 185359 C'FIVE D
Payment Date: 09/03/2008
Household 21346 S E P 0 8
Home Phone: (703)953 -1435 2008
Work Phone:
BY:
AMANDA KALLNER Monon Center
17751 VILLAGE BROOKE DRIVE EAST Carmel IN 46032
NOBLESVILLE IN 46062
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 71.75
Enrollee Name: Abigail Kallner Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 286121 -01 Mom -n -Me Gymnastics 18.25 0.00 0.00 18.25 0.00
Enrollment Date: 08/18/2008 (Cancelled)
Primary Instructor: Tumble Time
Class Location: Gymnasium C Class Dates: 09/02/2008 to 10/21/2008
Monon Center 10:30A to 11:OOA
Tu
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 8
Fee Details: Fee De Amount Count Di scount Sales Tax Total Fee
Mom -ne -Me Gymnastics 18.25 1.00 0.00 0.00 18.25
Cancel Reason: child did not enjoy the class prorated $7 surcharge
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 09/03/08 09:52:03 by CNA FEES CHANGED ON CANCELLED ITEMS 90.00-
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 18.25
NET AMOUNT. FROM CANCELLED.ITEMS 71.75•
TOTAL AMOUNT REFUNDED 71.75
NEW NET CREDIT HOUSEHOLD BALANCE 71.75
Refund of 71.75 Made By SYSTEM -GL With Reference child didn't like it
Rewards Points refunded on this receipt: 1.83
Household Reward Point Balance: 1.83
Page 1
ACTIVITY REFUND RECEIPT
Receipt 185361
Payment Date: 09/03/2008 71SEP CFITVE+ D
Household 21346
Home Phone: (703)953 -1435 0 8 2008
Work Phone:
BY:
AMANDA KALLNER Monon Center
17751 VILLAGE BROOKE DRIVE EAST Carmel IN 46032
NOBLESVILLE IN 46062
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Refund Details
Orio Bal Refund New Bal
Module: Activity Registration 71.75- 71.75 0.00
G/L Code_ Description Account Number Csl Cnt_r DescCiption_____________ Account.Number A_ mount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 71.75 DR
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 71.75
Processed on 09/03/08 10:01:55 by CNA NEW REFUND AMOUNT 71.75
TOTAL REFUNDABLE AMOUNT 71.75
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 71.75 Made By REFUND FINAN With Reference child didn't like it
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.
Authorized Signature Date Authorized Signature Date
y 30 0. y 35 (3y 0O o t;H-i)
Page 1
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.
Kallner, Amanda Terms
17751 Village Brooke Dr East Date Due
Noblesville, IN 46062
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/3/08 185361 Refund 71.75
Total 71.75
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.
Kallner, Amanda Allowed 20
17751 Village Brooke Dr East
Noblesville, IN 46062
I n Sum of
71.75
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or Board Members
Dept ept INVOICE NO. ACCT #/TITLE AMOUNT
1047 185361 4358400 71.75 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
9 -Sep 2008
Signature
71.75 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund