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164801 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: T361996 Page 9 ©f 1 v ONE CIVIC SQUARE ANNETTE KREIDER CHECK AMOUNT: $200.00 CARMEL, INDIANA 46032 9709 SEASIDE DR INDIANAPOLIS IN 46280 CHECK NUMBER: 164801 CHECK DATE: 10/16/2008 DEPARTMENT AC PO NU MBER INVOICE N UMBE R AMOUNT DESCRIPTION 1047 4356400 20.0.00 PARKS DEPARTMENT REFU a ACTIVITY REFUND RECEIPT Receipt 190778 REC FNVFD Payment Date: 09/30/2008 Household 18672 Home Phone: (317)443 -7513 OCT 0 1 2008 Work Phone: BY: ANNETTE KREIDER Monon Center 9709 SEASIDE DRIVE Carmel IN 46032 INDIANAPOLIS IN 46280 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Enrollment Details CANCELLATION Refund Of 200.00 Enrollee Name: Sophia Cenova Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 283018 -01 Adaptive Private Swi 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 08/01/2008 (Cancelled) Class Location: Indr Leisure Pool 1 Class Dates: 09/01/2008 to 12/31/2008 Monon Center 12:OOA to 12:OOA Carmel, IN 46032 M,Tu,W,Th,F,Sa (317)848 -7275 Scheduled Sessions: 105 Cancel Reason: Schedule Conflict 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 200.00 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 09/30/08 13:32:50 by TCP FEES CHANGED ON CANCELLED ITEMS 200.00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 NET AMOUNT FROM CANCELLED ITEMS 200.00- TOTAL AMOUNT REFUNDED 200.00 NEW NET HOUSEHOLD BALANCE 0.00 Refund of 200.00 Made By REFUND FINAN With Reference Schedule Conflict 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. Page #1 ACTIVITY REFUND RECEIPT Receipt 190778 Payment Date: 09/30/2008 Household 18672 o0 Authorized Signature Date Authorized Signature Date y� 3 LID() 0000 1'I Pa9e�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. Kreider, Annette Terms 9709 Seaside Drive Date Due Indianapolis, In 46280 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 9/30/08 190778 Refund 200.00 Total 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. Kreider, Annette Allowed 20 9709 Seaside Drive Indianapolis, In 46280 In Sum of 200.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 190778 4358400 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 7 -Oct 2008 Signature 200.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund