179367 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 360201 Page 1 of 1
ONE CIVIC SQUARE MARY JANE PERKINS CHECK AMOUNT: $22.00
s CARMEL, INDIANA 46032 1485 BEACONFIELD COURT
CARMEL IN 46033 CHECK NUMBER: 179367
CHECK DATE: 11/11/2009
"DEPARTMENT ACCOUNT PO NUMBER IN VOICE NUMBER AMOUNT DE SCRIPTION
'.1047 4358400 349962 22.00 REFUNDS AWARDS INDE
GLOBAL REFUND RECEIPT
Receipt 349962
Payment Date: 10131/09
Household 1209
Monon Center Mary Jane Perkins Hm Ph: (317)574 -1751
Carmel IN 46032 1485 Beaconfield Court Wk Ph: (317)574 -1751
Carmel IN 46033 Cell Ph: (317)224-6411
Phone: (317)848 -7275 mjp@ indy.rr.com,perkins @indy.rr.com
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 22.00
Enrollee Name: Mary Jane Perkins Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 294392 -11 Aqua Ai Chi 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 09/21/2009 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Class Dates: 11/05/2009 to 11/19/2009
Monon Center 8:30A to 9:20A
!J d
Carmel, IN 46032 Th
Scheduled Sessions: 3
(317)848 -7275
Skip Days 11/26/2009 NOV O 2 2009
Cancel Reason: low enrollment
BY:
G/L Code Descri Account Number Cst Cntr Descri Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 22.00 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 10/31/09 13:21:43 by TCP FEES CHANGED ON CANCELLED ITEMS 22.00
NET AMOUNT FROM= CANCELLED ITEMS:, .221`00 7 ,°n]
TOTAL AMOUNT`REFUNDED
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 22.00 Made By REFUND FINAN With Reference low enrollment
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
qq yds. 22�. y65gay-/
Page #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
Purchase Order No.
Perkins, Mary Jane Terms
1485 Beaconfield Court Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/31/09 349962 Refund 22.00
Total 22.00
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.
Perkins, Mary Jane Allowed 20
1485 Beaconfield Court
Carmel, IN 46033.
In Sum of
22.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 349962 4358400 22.00 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
"I
Signature
22.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund