169344 03/04/2009 CITY OF CARMEL, INDIANA VENDOR: T362593 Page 1 of 1
ONE CIVIC SQUARE SHERI ANN BALLARD CHECK AMOUNT: $10.00
CARMEL, INDIANA 46032 1078 THIRD AVE SW
CARMEL IN 46032 CHECK NUMBER: 169344
CHECK DATE: 3/4/2009
DEPARTMENT ACCOUNT PO NUMBER IN NUMBER AMOUNT DESCRIPTION
1047 4358400 230860 10.00 REFUNDS AWARDS INDE
�I
ACTIVITY REFUND RECEIPT
Receipt 230860
Payment Date: 02/19/2009
Household 24410
Home Phone: (317)815 -7000
Work Phone: (317)
FEB 2 5 2009
i
SHERI ANN BALLARD Monon Center
1078 THIRD AVE. SW Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 10.00
Enrollee Name: Sheri Ann Ballard Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 397800 01 Senior Health Fair 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 01/26/2009 (Cancelled)
Class Location: Program Rms A, B, C Class Dates: 02/21/2009 to 02/21/2009
Monon Center 8:OOA to 12:OOP
Sa
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 1
Cancel Reason: low enrollment
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 10.00 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 02/19/09 09:47:26 by MML FEES CHANGED ON CANCELLED ITEMS 10.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 10.00
TOTAL AMOUNT REFUNDED 10.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 10.00 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.
Page 1
ACTIVITY REFUND RECEIPT
Receipt 230860
Payment Date: 02/19/2009
Household 24410
1111% q
A6thorized Signature date Authorized Signature Date
43 igOO
Page 2
ACCOUNTS PAYABLE VOUCHER
r CITY OF CARMEL
4 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.
Ballard, Sheri Ann Terms
1078 Third Ave SW Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/19/09 230860 Refund 10.00
Total 10.00
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
Voucher No. Warrant No.
Ballard, Sheri Ann Allowed 20
1078 Third Ave SW
Carmel, IN 46032
In Sum of
10.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 230860 4358400 10.00 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
26 -Feb 2009
1 i0,a�'.�o yYn, eh,)
Signature
10.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund