171835 04/29/2009 F CITY OF CARMEL, INDIANA VENDOR: 36200. Page 1 of 1
ONE CIVIC SQUARE GRETCHEN FARE
CARMEL, INDIANA 46032 10906 JORDAN ROAD CHECK AMOUNT: $58.00
CARMEL IN 46032
�o CHECK NUMBER: 171835
CHECK DATE: 4129/2009
DEPARTMENT AC COUNT PO NUMBER IN VOIC E NUMBER DESCRIP
1047 4358400 251671 58.00 REFUNDS AWARDS INDE
M1
i
ACTIVITY REFUND RECEIPT
Q
Receipt 251671
Payment Date: 04/20/2009 A P R 2 2
Household 18668 209
Home Phone: (815)790 -6882
Work Phone:
GRETCHEN FARB Monon Center
10906 JORDAN RD Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 58.00
Enrollee Name: Noah Farb Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 393002 -01 Splashin' Tot 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 12/01/2008 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Indr Leisure Pool 2 Class Dates: 01/10/2009 to 03/14/2009
Monon Center 9:45A to 10:15A
Sa
Carmel IN 46032 Scheduled Sessions: 10
(317)848 -7275
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Splashin' Tot 7.00 1.00 0.00 0.00 7.00
Cancel Reason: Noah did not enjoy the classes so parent took him out.
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 58.00 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 04/20/09 06:36:57 by ALC FEES CHANGED ON CANCELLED ITEMS 65.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 7.00
NET AMOUN— FROWCANCELLED x`58:00
TOTALAMOUNTREFUNDEDk ftX 58.00;
NEW NET HOUSEHOLD BALANCE 0.00
Page 1
ACTIVITY REFUND RECEIPT
Receipt 251671
Payment Date: 04/20/2009
Household 18668
Refund of 58.00 Made By REFUND FINAN 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 card refunds.
ALLCM 141 0 i I
Authorized Signature Date Authorized Signatur Date
q 7 �30 30 G/3�
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.
Farb, Gretchen Terms
10906 Jordan Rd Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4120109 251671 Refund 58.00
Total 58.00
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
20_
Clerk- Treasurer
Voucher No. Warrant No.
Farb, Gretchen Allowed 20
10906 Jordan Rd
Carmel, IN 46032
In Sum of
58.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 251671 4358400 58.00 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
22 -Apr 2009
Signature
58.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund