168951 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: T362560 Page 1 of 1
ONE CIVIC SQUARE CHRISTI EGGLESTON CHECK AMOUNT: $30.00
CARMEL, INDIANA 46032 1334 EAST BEACON WAY
CARMEL IN 46032
CHECK NUMBER: 168951
CHECK DATE: 2/1712009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4:358400 225327 30.00 REFUNDS AWARDS INDE
e_
ACTIVITY REFUND RECEIPT
Receipt 225327 C E.TVED
Payment Date: 02/05/2009 FEB 1 1 2009
Household 10585
Home Phone: (317)705 -1856
Work Phone: BY:
CHRISTI EGGLESTON Monon Center
1334 EAST BEACON WAY Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax I D #35- 6000972
Enrollment Details
CANCELLATION Refund Of 30.00
Enrollee Name: Shea Eggleston Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 396312 -02 After School Dodgeba 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 01/28/2009 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Gymnasium C Class Dates: 02/02/2009 to 03/23/2009
Monon Center 4:OOP to 5:00P
M
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 8
Cancel Reason: low enrollment
GIL Co de Description Account Numbe C st Cntr Descrip Acco Number A mount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 30.00 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 02105/09 14:47:08 by LVA FEES CHANGED ON CANCELLED ITEMS 30.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 30.00-
TOTAL AMOUNT REFUNDED 30.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 30.00 Made By REFUND FINAN With Reference low enrollment
Page 1
r ACTIVITY REFUND RECEIPT
Receipt 225327
Payment Date: 02/05/2009
Household 10585
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issue No cash or credit card refunds.
Authorized Sin lure Da a Authorized Signature Date
u7 qCO. wa3. gboo
ell ra,
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.
Eggleston, Christi Terms
1334 East Beacon Way Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2!5!09 225327 Refund 30.00
Total 30.00
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.
Eggleston, Christi Allowed 20
1334 East Beacon Way
Carmel, IN 46032
In Sum of
30.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITL AMOUNT Board Members
Dept
1047 225327 4358400 30.00 l 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
13 -Feb 2009
azz--j
Signature
30.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund