179359 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 363556 Page 1 of 1
ONE CIVIC SQUARE JENNIFER PARK
CARMEL, INDIANA 46032 425 KIMBROUGH LANE CHECK AMOUNT: $85.00
CARMEL IN 46032
CHECK NUMBER: 179359
CHECK DATE: 11/11/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 350292 85.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 350292
Payment Date: 11/02/09
Household 4504
Mon on Center Jennifer Park Hm Ph: (317)815 -8411
Carmel IN 46032 425 Kimbrough Ln Wk Ph: (317)817 -2595
Carmel IN 46032 Cell Ph.
jpark0924 @att.net
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 85.00
Enrollee Name: Jasmine Park Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 296409 -01 Cooking 101 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 10/10/2009 (Cancelled)
Class Location: Kiss Z Cook Class Dates: 11/04/2009 to 11/04/2009
KissZCook 6:30P to 8:30P
390 E. 116th St. Ste 12-5 W
Carrnel, IN 46032 Scheduled Sessions: 1
(317)815 -0681
Cancel Reason: low enrollment
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 85.00 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 11/02/09' 10:42:13 by LVA FEES CHANGED ON CANCELLED ITEMS 85.00
NET AMOUNT FROM CANCELLED ITEMS 85.00
TOTAL AMOUNT REFUNDED 85.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 85.U.' Made By REFUND F161AN With Reference low enrollment
All refunds are subect to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. o cash cr credit card refunds.
Authorized Sign a re 6ato Authorized Signature Date
Es QW 9 W/ 3 D
a NOV 0 4 2009
BY
Page 1
1 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
A Purchase Order No.
Park, Jennifer Terms
425 Kimbrought Ln Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1112109 350292 Refund 85.00
Total 85.00
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.
Park, Jennifer Allowed 20
425 KimbroughVLn
Carmel, IN 46032
In Sum of
85.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 350292 4358400 85.00 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 -Nov 2009
Signature
I 85.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund