169805 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: T356710 Page 1 of 1
ONE CIVIC SQUARE LISA AMICH
CARMEL, INDIANA 46032 CHECK AMOUNT: $32.00
138 COOL CREEK BLVD #2
4,_ CARMEL IN 46032 CHECK NUMBER: 169805
CHECK DATE: 3/1812009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4358400 32.00.PARKS DEPARTMENT REFU
r
ACTIVITY REFUND RECEIPT
Receipt 233316 �7 1p
Payment Date: 02/27/2009
Household 24783 MAR 0 3 2009
Home Phone: (765)242 -4910
Work Phone:
LISA AMICH Carmel Elementary
138 COOL CREE BLVD. APT. 2 101 4th Avenue SE
CARMEL IN 46032 Carmel IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 32.00
Enrollee Name: Brittany Mullins Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 486017 01 Basketball with Char 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 02/17/2009 (Cancelled)
Class Location: Carmel Elem School Class Dates. 03/0212009 to 03/23/2009
CarmelClayParksRec 2:45P to 3:45P
101 4th Avenue SE M
Carmel, IN 46033
(317)848-7275 Scheduled Sessions. 4
Cancel Reason: E class cancelled
G. /L__C.ode Description Account_ Number__. Cst Cntr_ Description Account Number_ Am_ ou_nt
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 32.00 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 02/27/09 08:35:07 by JCM FEES CHANGED ON CANCELLED ITEMS 32.00
L� DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
r
0 01— SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 32.00
d TOTAL AMOUNT REFUNDED 32.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of ==I--- 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.
Page 1
ACTIVITY REFUND RECEIPT
Receipt 233316
Payment Date: 02/27/2009
Household 24783
Authorized Signature Date Authorized Signature Date
Page 2
ACCOUNTS PAYABLE VOUCHER
J 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.
Amich, Lisa Terms
138 Cool Cree Blvd Apt 2 Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/27/09 233316 Refund 32.00
Total 32.00
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.
Amich, Lisa Allowed 20
138 Cool Cree Blvd Apt 2
Carmel, IN 46032
In Sum of
32.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 233316 4358400 32.00 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
12 -Mar 2009
Signature
32.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund