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178143 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 363402 Page 1 of 1 ONE CIVIC SQUARE CARLA FEAGANS �i CHECK AMOUNT: $40.00 s. CARMEL, INDIANA 46032 2025 RHETTSBURY ST CARMEL IN 46032 CHECK NUMBER: 178143 CHECK DATE: 10/14/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION X047 4358400 341707 40.00 REFUNDS AWARDS INDE ACTIVITY REFUND RECEIPT Receipt 341707 Payment Date: 10/02/2009 Household 20087 II Home Phone: (317)645 -3627 OCT 0 7 2009 CARLA FEAGANS Monon Center 2025 RHETTSBURY ST Carmel IN 46032 CARMEL IN 46032 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Enrollment Details CANCELLATION Refund Of 40.00 Enrollee Name: Carla Feagans Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 299002 -01 Family Campout 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 09/18/2009 (Cancelled) Class Location: West Park Shelter Class Dates: 09/25/2009 to 09/26/2009 West Park 4:30P to 9:OOA 2700 W. 116th St. F,Sa Carmel, IN 46032 Scheduled Sessions: 2 (317)848 -7275 Cancel Reason: advanced request G/L Code Description Account Number Cst Cntr Descri Acco Number Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 40.00 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 10/02/09 12:44:40 by SAC FEES CHANGED ON CANCELLED ITEMS 40.00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 NET AMOUNT FROM CANCELLED ITEMS 40.00 TOTAL AMOUNT REFUNDED 40.00 NEW NET HOUSEHOLD BALANCE 0.00 Refund of 40.00 Made By REFUND FINAN With Reference advanced request 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 341707 Payment Date: 10/02/2009 Household 20087 Authorized Signature Date Authorized Signature Date 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. Feagans, Carla Terms 2025 Rhettsbury St Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 1012109 341707 Refund 40.00 Total 40.00 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. Feagans, Carla Allowed 20 2025 Rhettsbury St Carmel, IN 46032 In Sum of 40.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT#rrITLE AMOUNT Board Members Dept 1047 341707 4358400 40.00 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 2009 Signature 40.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund