178185 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 363403 Page 1 of 1
ONE CIVIC SQUARE ROLLIN HARRISON
CHECK AMOUNT: $46.00
%o CARMEL, INDIANA 46032 1190 WODOGATE DR
CARMEL IN 46033 CHECK NUMBER: 178185
CHECK DATE: 10114/2009
DEPARTMEN ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 339791 46.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 339791
Payment Date: 09123!2009 SEP
Household 374 20a9
Home Phone: (317)580 -9527
Work Phone: (317)
ROLLIN HARRISON Morton Center
1190 WOODGATE DR. Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 46.00
Enrollee Name: Jo Anne Harrison Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 296295 -01 Planet Pop Star 0.00 0.00 0 -00 0.00 0.00
Enrollment Date: 08/24/2009 (Cancelled)
Class Location: Art Studio Class Dates. 09/19/2009 to 09/26/2009
Morton Center 10:OOA to 11 .00A
Sa
Carmel, IN 46032 Scheduled Sessions: 2
_(317)848 -7275
Cancel Reason: Advanced Request
G/L Code Description Account Nu mber Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 46.00 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 09/23/09 10:04:24 by LVA FEES CHANGED ON CANCELLED ITEMS 46.00-
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 46.00
TOTAL AMOUNT REFUNDED 46.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 46.00 Made By REFUND FINAN With Reference advanced request
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# 339791
Payment Date: 09123/2009
Household 374
Authorized Sig ure Date Authorized Signature Date
woo
CO
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.
Harrison, Rollin Terms
1190 Woodgate Dr Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/23109 339791 Refund 46.00
Total 46.00
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
r
Voucher No. Warrant No.
Harrison, Rollin Allowed 20
1190 Woodgate Dr
Carmel, IN 46033
In Sum of
46.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 339791 4358400 46.00 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 -Oct 2009
Signature
46.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund