172122 04/30/2009 CITY OF CARMEL, INDIANA VENDOR: 362797 Page 1 of 1
0 ONE CIVIC SQUARE STACEY BLANSETTE CHECK AMOUNT: $54.00
�o CARMEL, INDIANA 46032 14630 DEERWOOD DRIVE
CARMEL IN 46033 CHECK NUMBER: 172122
CHECK DATE: 4/30/2009
DEPAR TMENT AC COUN T PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
J 1047 4358400 242652 54.00 REFUNDS AWARDS INDE
L GLOBAL REFUND RECEIPT
Receipt 242652
Payment Date: 03/26/2009
Household 108 r i;l
Home Phone: (317)215 -7071
Work Phone: (317)313 -6608 APR 1 6 2009
D.Y:.......................
STACEY BLANSETTE Monon Center
14630 DEERWOOD DRIVE Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 54.00
Enrollee Name: Forrest Blansette Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 383018 -01 SN Private Lessons 126.00 0.00 0.00 126.00 0.00
Enrollment Date: 03/28/2008 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Pool Private Lessons Class Dates: 01/14/2008 to 04/26/2008
Monon Center 8:OOA to 7:OOP
M,Tu,W,Th,F,Sa
Carmel IN 46032 Scheduled Sessions: 90
(317)848 7275
Fee Details: Fee Description Amount Co unt Discount Sales Tax Total Fee
One -on -One Resident 126.00 1.00 0.00 0.00 126.00
Cancel Reason: No longer taking lesson
G1L Code Descrip Account Number Cst Cntr De_script ion
A ccount Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 54.00 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 03/26/09 16:08:25 by TCP FEES CHANGED ON CANCELLED ITEMS 180.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 126.00
�'NET;A'MOUNT;F ROM �CANCELLED :ITEMS` X54:00;
TOTAL.AMOUNT REFUNDED'
5440
NEW NET HOUSEHOLD BALANCE 0.00
Page 1
GLOBAL REFUND RECEIPT
Receipt 242652
Payment Date: 03/26/2009
Household 108
Refund of 54.00 Made By REFUND FINAN with Reference No longer taking
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.
Authorized Signa Date Authorized Signature Date
D
APR 1 6 2009
BY:
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.
Blansette, Stacey Terms
14630 Deerwood Drive Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) Amount
54.00
3!26109 242652 Refund
Total 54.00
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.
Blansette, Stacey Allowed 20
14630 Deerwood Drive
Carmel, IN 46033
In Sum of
54.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE N0, ACCT #/TITL AMOUNT Board Members
Dept II
1047 242652 4358400 54,00 1 hereby certify that the attached invoice(s), or i
hill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
22 -Apr 2009
Signature
54.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund