161218 07/08/2008 CITY OF CARMEL, INDIANA VENDOR: T361495 Page 1 of 1
ONE CIVIC SQUARE LISSA KEHAYA- BILLANTI
CARMEL, INDIANA 46032 14360 CHARIOTS WHISPER DR CHECK AMOUNT: $83.00
WESTFIELD IN 46074
CHECK NUMBER: 161218
CHECK DATE: 7/8/2008
DEPARTMENT ACCOUNT PO NUMBE INVOICE N UMBER AMOUNT DESCRIPTION
1047 4358400 137965 83.00 REFUNDS AWARDS INDE
I
ACTIVITY REFUND RECEIPT
Receipt 137965 7 D
Payment Date: 06/24/2008
Household 3097
Home Phone: (317)848 -2607 JUN 2 6 2008
Work Phone:
B'Y:
LISSA KEHAYA BILLANTI Carmel Clay Parks Recreation
14360 CHARIOTS WHISPER DRIVE 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 83.00
Enrollee Name: Remi Blllanti Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 185004 -01 Lil' Kickers Cottont 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 05/07/2008 (Cancelled)
Primary Instructor: Off the Wall Sports
Class Location: West Park Field Class Dates: 06/03/2008 to 08/05/2008
West Park 10:30A to 11:20A
2700 W. 116th St. Tu
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 10
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Lil' Kickers Cottont 7.00 1.00 0.00 0.00 7.00
Cancel Reason: new job conflict
G Co de Descri Acco N umbe r C Cntr De Accou N umbe r Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 83.00 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 06/24/08 12:30:33 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 7.00
NET AMOUNT FROM CANCELLED ITEMS 83.00
TOTAL AMOUNT REFUNDED 83.00
NEW NET HOUSEHOLD BALANCE 0.00
Page 1
ACTIVITY REFUND RECEIPT
Receipt 137965
Payment Date: 06/24/08
Household 3097
Refund of 83.00 Made By JOURNAL -RF With Reference new job conflict
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 wee s process. c eck will be
issued. No cash or credit card refunds.
Au orized Signature Date A t nze igna ure Date
RF
JUN 2 6 2008
_Q�T.
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.
Kehaya Billanti Lissa Terms
14360 Chariots Whisper Drive Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/24/08 137965 Refund 83.00
Total 83.00
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
Voucher No. Warrant No.
Kehaya- Billanti Lissa Allowed 20
14360 Chariots Whisper Drive
Westfield, IN 46074
In Sum of
83.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 137965 4358400 83.00 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
27 -Jun 2008
Signature
83.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
ENTERED