172296 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 362847 Page 1 of 1
ONE CIVIC SQUARE SHARON DONNELLY CHECK AMOUNT: $53.00
CARMEL, INDIANA 46032
11079 HUNTINGTON CT
CARMEL IN 46033 CHECK NUMBER: 172296
CHECK DATE: 5/13/2009
DEPARTMENT ACCO P O NUMBER I NUMBER AMOUNT DESCRIPTION
1047 4358400 253477 53.00 REFUNDS AWARDS INDE
II
ACTIVITY REFUND RECEIPT
Receipt 253477
I
Payment Date: 04/27/2009 it
Household 676 APR 2 8 2009
Home Phone: (317)815 -5991
Work Phone: (317)
SHARON DONNELLY Monon Center
11079 HUNTINGTON CT. Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 53.00
Enrollee Name: Joel Donnelly Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 196425 -01 Safe Sitter 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 03/19/2009 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Program Rms A, B, C Class Dates: 05/02/2009 to 05/02/2009
Monon Center 9:00A to 4:OOP
Sa
Carmel, IN 46032 Scheduled Sessions: 1
(317)848 -7275
Fee Details: Fee Description______ _Amount Count Discount_ Sale Tax _T otal Fee
Safe Sitter Resident 7.00 1.00 0.00 0.00 7.00
Cancel Reason: unable to atttend
G/L Code Description—__ Acco unt Number Cst Cntr De Account N Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 53.00 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 04/27/09 14:40:01 by LVA FEES CHANGED ON CANCELLED ITEMS 60.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 7.00
NET AMOUNT FROM CANCELLED ITEMS 53.00
TOTAL AMOUNT REFUNDED 53.00
NEW NET HOUSEHOLD BALANCE 0.00
Page 1
ACTIVITY REFUND RECEIPT
Receipt 253477
Payment Date: 04/27/2009
Household 676
Refund of 53.00 Made By REFUND FINAN With Reference time conflict
Rewards Points refunded on this receipt: 0.70
Household Reward Point Balance: 6.70
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.
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Authorized nature Date Authorized Signature Date
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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.
Donnelly, Sharon Terms
11079 Huntington Ct. Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/27/09 253477 Refund 53.00
Total 53.00
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.
Donnelly, Sharon Allowed 20
11079 Huntington Ct.
Carmel, IN 46033
In Sum of$
53.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 253477 4358400 53.00 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
53.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund