173123 06/02/2009 CITY OF CARMEL, INDIANA VENDOR: 359600 Page 1 of 1
ONE CIVIC SQUARE HELEN BALLINGER CHECK AMOUNT: $200.00
;y r CARMEL, INDIANA 46032 12913 CURRIER STREET
CARMEL IN 45032 CHECK NUMBER: 173123
CHECK DATE: 6/212009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
4128000 200.00 TUITION REIMBURSEMENT
Carrel Clay
Parks &Recreation CHECK REQUEST
Date: 5 -15 -09 MAY 1 5 2009
Check payable t BY:
o
Name: Helen Ballinger
Address: 12913 Currier Street
City, State, Zip Carmel, IN 46032
Mail check to payee NV II,
Return check to requestor
Check Amount 200.00 Date Required Next claims cycle
Check needed for Tuition Reimbursement
To be paid from
PO (if applicable)
Budget account GL 101 1125- 4128000
Budget Line Description Tuition reimbursement
Invoice(s) and Purchase Order (if required) MUST be attached.
Requested by (print): Audrey Kostrzewa
Requested by (signature):
Approved by (signature of Division Manager): d
on this date L 5- /.S —0
Form revised 7 -7 -08 Shared Administrative Forms Staff forms Check Request (rev 7 -7 -08)
Carmel 0 Clay
Parks &Recreation
Tuition Reimbursement Application Form
Part I (to be completed by employee)
(Please print. Submit completed form to Supervisor prior to commencement of course.)
W Employee Name 4
Date
Education Institution U U,,
Name of Course 6 61 I 0 O+OtLe, �eyk
SemesterNear of Course J o�, 0 0
I understand that to receive reimbursement for this course, I must submit evidence of payment for the
course and a copy of my final grade. To receive reimbursement for books, I must submit the book list
for the course and an original itemized receipt for all books purchased. The amount of the
reimbursement is subject to the outlines in the Personnel Policy Handbook adopted by the Carmel /Clay
Board of Parks and Recreation. f a
Employee Signature Date
Supervisor Signature Date ur U
Part 11 (to be completed by Assistant Director)
(Submit to Human Resources)
By signing below, I certify that the applicant will have been employed full -time by the Carmel Clay
Parks and Recreation Department for at least one (1) year prior to the commencement of the course,
and has not been subject to a disciplinary probation, suspension or demotion within 90 days prior to the
beginning of the course. The final claim will be paid from my department's budget, subject to the
terms outlined in the Personnel Policy Handbook.
Asst Director Signature Date
The tuition reimbursement program covers only full- semester courses offered through a degree- granting institution
accredited by the North Central Association of Colleges and Schools.
*An application will not be considered complete unless a course description from the school's literature is attached.
:1
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Archived Course Offerings SOC
R498
Other Course Listings Sociology Capstone Seminar
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1.1.
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Student Center a�
Helen Ballinger
Sea rch for Classes Academic Planning My Acade mics Grades
View My Grades
Spring 2009 1 Undergraduate I IUPUI change term
Class Grades Spring 2009
Official Grades
1.Class Description Units Grade Grade Points
I� 3.0
SOCIOLOGY CAPSTONE
SOC -R 498 3.00 A 12.000 3
SEMINAR
Term Statistics Spring 2009
From Combined Cumulative
From Transfer Term'
Enrollment I Total
Credit Total
.Wd
;T otal G rade Points 24.000 24.000 119.1001
'Graded units t owards GPA j 6.000 6 000 30.000
3 97 000
,Graded units not for G
In progress units
GPA 4.000
4.000 1 3.970
GPA Total Grade Points Graded units towards GPA
Transfer Credit column information reflects the Transfer, Test and Special /Other Credit for
this term.
Statistics represent the grade points and hours as evaluated by the academic policies of
your academic school /program.
Go to "My Academics Grades" to run an Indiana University unofficial transcript to view
your Indiana University GPA and Hours in addition to your Student Program statistics.
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https: /iuself. iu. edtl/psc /S SERV /SI S SELFSERV ICE /HRMS /c /SA_LEARN ER_SERV ICE... 5/13/2009
MISC. INCOME DONATION MONEY PROCESSING
Business Services will enter the donation money in RecTrac when received. A daily
cash journal will be printed and submitted to Revenue Coordinator for deposit.
PERIOD END`— GLOBAL— GLOBAL MISC INC EXP POSTINGS
Click MISC button.
Click POST DETAILS. (See screen below)
X
Func Gbbal Act iy Fadllty Pass POS Incdnt Sys[
W t•'4
7 A
r
Module !li AdMty J Facility rJ Rental J a rI Lockets J League rJ i:d
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r
I
rr yy, I S
Rd�a�
a
4 in RecTrac Admin:stra[o... W.1 AM
On next screen (see next page):
Click ADD and enter POSTING DATE and AMOUNT.
Indicate POSTING TYPE: INCOME
Indicate DESCRIPTION, such as: Gaylor- Arbor Day Sponsorship
More detail can be entered in NOTES.
Choose G/L Code: Check carefully for the appropriate code to coincide with
Pentamation revenue accounts.
NDIANA U NIVER S ITY O IUPUI Office
Box 6 20 f the Bursar
Account Statement
Statement Date: 12/02/08 Page 1 of 1 y�{ tt t s j tp *sh ue t t8' 12/16/08
Billing Reference: IN BILL# XXX1358091 vt)ojeuli:tisl ancej 0.00
University ID: 0001844572 r j �k raNli�rirtiuti�D 9i 906.77
Student Name: Ballinger,Welen �avpyprpjx
2,204.42
Statement notification sent to hiballin @iupui.edu
t
Charges and Adjustments
11/13/08 Activity Fee 68.45
11/13/08 Technology Fee 118,10
11/13/08 Athletic Development Fee (SAF) 38.57
11113/08 Resident Undergraduate Fees 1,959.30
11/13/08 General Services Fee 20.00
TotalCharges and Adjustments: 2,204.42
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Messages
Paying at least the minimum payment amount due as indicated will enroll you in the installment plan program. There will be a non refundable
Please see a copy of the IUPUI Bursar newsletter at www.bursar.iupui.edu
The University reserves the right to restrict services, deny registration, impose late fees, assess returned item service charges, terminate any
If paying by check we may choose to convert your paper check into an electronic transaction. The amount of your check may appear as an electronic
You agree that if another person submits a check on your behalf, that individual is considered your agent and was provided with the information on
F r
I N D I N UNIVERSITY O 020 of the Bursar
Account Statement
Statement Date: 01/06/09 Page 1 of 1 ti:, ;,'�;'!`M #sw4 "Due,. „aE 01120/09
Billing Reference: IN BILL# XXX1392251 r s����, ire iS,a 2,204.42
UniversitylD:0001844572 ti5'tilYttile 72.25
Student Name: Ballinger,Helen 72.25
Statement notification sent to hibaliin @iupui.edu
r ...p -n r tF t L m'mPr;: r a.,;r Cr TEa Y,1.. t��.. y •5;- .'4. h. a �i x g arry rc;�
Charges and Adjustments
12/12/08 Parking Permit 72.25
12/22108 Resident Undergraduate Fees 653.10 CR
12124108 Refund 2,737.00
01102109 Refund 1,185.68
Total Charges and Adjustments: 3,341.83
Payments and Financial Aid
12/23/08 Federal Direct Sub Loan 2 2,737.00 CR
01/02109 Federal Direct Sub Loan 2 2,737.00 CR
Total Payments and Financial Aid: 5,474,00 CR
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.f�•..s�i„ %��,;�f,�.aa�� ..,r'..,..k. !"kF i; r�Crj l� t1: S. ��kr, r,: flTii, 7; 5�) �s. riS` ir�diti .'�ixerwAa�.t��aasv�,n�� }��i'3 s?fis.'"7:.�4t?fL�i a- c;3, r. 4ffhl��t r ww 7 7 4r',.�.:Jhry�
Messages
Please see a copy of the IUPUI Bursar newsletter at www,bursar.iupui.edu
The University reserves the right to restrict services, deny registration, impose late fees, assess returned item service charges, terminate any
If paying by check we may choose to convert your paper check into an electronic transaction. The amount of your check may appear as an electronic
You agree that if another person submits a check on your behalf, that individual is considered your agent and was provided with the information on
Make payment online at http:llonestart.iu.edu
.INDIANA U O 020 f the Bursar
Account Statement
Statement Date: 02103/09 Page 1 of 1���,t xdz,�,�?u A 02/17/09
Billing Reference: IN BILL# XXX1440890'rbuiu?,k`:a 72.25
University ID: 0001844572 r iE ,'�tiifiitrtU,iJt 0.00
Student Name: Ballinger,Helens ,rwr� i #to I u 0.00
Statement notification sent to hiballin @iupui.edu
!4 s.U".c'�v
Payments and Financial Aid
01/08/09 Payment by Web Credit Card 72.25 C R
Total Payments and Financial Aid: 72.25 C R
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�'�.-...m ;Y�ai'Fr�, •tl +w�u_iHZf Hie,, �'s i, u' T
d.. w.r w..
Messages
Please see a copy of the IUPUI Bursar newsletter at www.bursar.iupui.edu
The University reserves the right to restrict services, deny registration, impose late fees, assess returned item service charges, terminate any
If paying by check we may choose to convert your paper check into an electronic transaction. The amount of your check may appear as an electronic
You agree that if another person submits a check on your behalf, that individual is considered your agent and was provided with the information on
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,
359600 Ballinger, Helen Terms
12913 Currier Street
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5115/09 Reimb Tuition reimbursement 200.00
Total 200.00
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.
359600 Ballinger, Helen Allowed 20
12913 Currier Street"
Carmel, IN 46032
In Sum of
200.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1125 Reimb 4128000 200.00 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
21 -May 2009
Signature
200.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund