172330 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 362849 Page 1 of 1
ONE CIVIC SQUARE JOHN GOODRICH CHECK AMOUNT: $20.00
CARMEL, INDIANA 46032 728 WINTER WAY
«o CARMEL IN 46032 CHECK NUMBER: 172330
CHECK DATE: 5/13/2009
DEPARTMENT ACCOUNT PO NUMBER INVO NUMBER A MOUN T DESCRIPTION
1046 4358400 253926 20.00 REFUNDS AWARDS INDE
1 ACTIVITY REFUND RECEIPT
Receipt 253926 APR y 2009 y
Payment Date: 04/29/2009
Household 9106
Home Phone: (317)580 -1058
Work Phone: BY:
JOHN GOODRICH Carmel Elementary
728 WINTER WAY 101 4th Avenue SE
CARMEL IN 46032 Carmel IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 20.00
Enrollee Name: Lara Goodrich Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 486019 -02 Cheerleading 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 03/25/2009 (Cancelled)
Class Location: Carmel Elem School Class Dates: 05/05/2009 to 05/26/2009
CarmelClayParksRec 2:45P to 3:45P
101 4th Avenue SE Tu
Carmel, IN 46033 Scheduled Sessions: 4
(317)848 727_5
Cancel Reason: E2 Class cancelled
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 20.00 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 04/29/09 08:18:55 by JCM FEES CHANGED ON CANCELLED ITEMS 20.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS
TOTAL AMOUNT AMOUNT REFUNDED 20.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 20.00 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 253926
Payment Date: 04/29/2009
Household 9106
Annnature 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.
Goodrich, John Terms
728 Winter Way Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/29/09 253926 Refund 20.00
Total 20.00
I 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
Y
AN-
Voucher No. Warrant No.
Goodrich, John Allowed 20
728 Winter Way
Carmel, IN 46032
In Sum of
20.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1046 253926 4358400 20.00 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 -May 2009
Signature
20.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund