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169860 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: T362668 Page 1 of 1 ONE CIVIC SQUARE COLEMAN, STACY CHECK AMOUNT: $35.00 CARMEL, INDIANA 46032 10357 N COLLEGE AVE INDIANAPOLIS IN 46280 CHECK NUMBER: 169860 CHECK DATE: 3/18/2009 DEPARTMENT ACCO PO NUMBER INVOICE NUM AMOUNT DESCRIPTION 1047 4358400 35.00 PARKS DEPARTMENT REFU C ACTIVITY REFUND RECEIPT Receipt 232734 7MA 2 2009 Payment Date: 02/25/2009 Household 20808 Home Phone: (317)843 -0747 Work Phone: (317)814 -8400 A STACY COLEMAN Monon Center 10357 NORTH COLLEGE AVE. Carmel IN 46032 INDIANAPOLIS IN 46280 Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Enrollment Details CANCELLATION Refund Of 35.00 Enrollee Name: Kasey Coleman Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 398087 -02 Indoor Bowling 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 01/11/2009 (Cancelled) Primary Instructor: CCPR Staff Class Location: Gymnasium B Class Dates: 03/08/2009 to 04/19/2009 Monon Center 2:OOP to 3:OOP Su Carmel, IN 46032 Skip Days 04/05/2009 (317)848 -7275 Scheduled Sessions: 6 Cancel Reason: Low enrollment G/L Code Descri Account Number Cst Cntr Description Account Number Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 35.00 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 02/25/09 15:40:51 by BNT FEES CHANGED ON CANCELLED ITEMS 35.00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 NET AMOUNT FROM CANCELLED ITEMS 35.00 TOTAL AMOUNT REFUNDED 35.00 NEW NET HOUSEHOLD BALANCE 0.00 Refund of 35.00 Made By REFUND FINAN With Reference check Page 1 ACTIVITY REFUND RECEIPT Receipt 232734 Payment Date: 02/25/2009 Household 20808 '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 crpdit card refunds. Authorized Signatur Date Authorized Signature Date 9W 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. Coleman, Stacy Terms 10357 North College Ave Date Due Indianapolis, IN 46280 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 2125/09 232734 Refund 35.00 Total 35.00 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 1 20 Clerk- Treasurer Voucher No. Warrant No. Coleman, Stacy Allowed 20 10357 North College Ave Indianapolis, IN 46280 In Sum of 35.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TlTLE AMOUNT Board Members Dept 1047 232734 4358400 35.00 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 12 -Mar 2009 Signature 35.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund