166880 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: T362236 Page 1 of 1
ONE CIVIC SQUARE LORI SCOTT- SOLAZZO
CARMEL, INDIANA 46032 15412 WILDFLOWER COURT CHECK AMOUNT: $21.00
WESTFIELD IN 46074 CHECK NUMBER: 166880
CHECK DATE: 12/10/2008
DEPARTMENT ACCOUNT PO NUMBER I NUMBER AMOUNT DESCRIPTION
1047 4358400 202891 21.00 REFUNDS AWARDS INDE
�z r ACTIVITY REFUND RECEIPT
Receipt 202891 DEC 0 1 2008
Payment Date: 11/17/2008
Household 21134
Home Phone: (317)815 -9832
Work Phone: (317)
LORI SCOTT SOLAZZO Monon Center
15412 WILDFLOWER COURT Carmel IN 46032
WESTFIELD IN 46074
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 21.00
Enrollee Name: Lori Scott- SOIazzo Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 284200 -07 Zumba 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 09/03/2008 (Cancelled)
Primary Instructor: Zumba
Class Location: Fitness Studio B Class Dates: 12/02/2008 to 12/16/2008
Monon Center 6:OOP to 6:50P
Tu
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 3
Fee Details: Fee Desc riptio n Amount Count Discount Sales Tax Total _F
Zumba 7.00 1.00 0.00 0.00 7.00
Cancel Reason: Not satisfied with class.
G/L Code Description Account Number Cst Cntr Descriptio Ac count Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 21.00 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 11/17/08 12:08:23 by CEK FEES CHANGED ON CANCELLED ITEMS 28.00
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
00.
TOTAL AMOUNT REFUNDED 21.00
NEW NET HOUSEHOLD BALANCE 0.00
Page 1
ACTIVITY REFUND RECEIPT
Receipt 202891
Payment Date: 11/17/2008
Household 21134
'Refund of 21.00 Made By REFUND FINAN With Reference class cancellatioin
Rewards Points refunded on this receipt: 0.70
=.Household Reward Point Balance: 31.50
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
34C, zoo. y 35$ y csu
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.
Scott Solazzo, Lori Terms
15412 Wildflower Court Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/17/08 202891 Refund 21.00
Total 21.00
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.
Scott Solazzo, Lori Allowed 20
15412 Wildflower Court
Westfield, IN 46074
In Sum of
21.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1047 202891 4358400 21.00 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
5 -Dec 2008
Signature
21.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund