178190 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 363404 Page 1 of 1
ONE CIVIC SQUARE JOHN HILDENBRAND
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CARMEL, INDIANA 46032 1035 OSVYEGO ROAD CHECK AMOUNT: $126.00
CARMEL IN 46032 CHECK NUMBER: 178190
CHECK DATE: 1 011 412 0 0 9
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB A MOUNT DESCRIPTION
1047 m 4358400 342606 126.00 REFUNDS AWARDS INDE
r
ACTIVITY REFUND RECEIPT
Receipt 342606 r.
Payment Date: 10/06/2009
Household 29118 OCT C 7 2009
Home Phone: (317)564 -8096
B YD
JOHN HILDENBRAND Monon Center
1035 OSWEGO RD Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 42.00
Enrollee Name: Elizabeth Hildenbrand Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 297110 -01 Chinese Cross Cultur 0.00 0.00 0.00 0.00 0:00
Enrollment Date: 0$105/2009 (Cancelled)
Class Location: Banquet Room A Class Dates: 10/03/2009 to 10/0312009
Monon Center 10:OOA to 12:OOP
Sa
Carmel, IN 46032 Scheduled Sessions: 1
(317)848 -7275
Add'l Locations: Banquet Room B Class Dates: 10/03/2009
Monon Center Meeting Times (Sa)10:OOA to 12:OOP
Carmel, IN 46032
3178487275
Cancel Reason: low enrollment
CANCELLATION Refund Of 42.00
Enrollee Name: Elizabeth Hildenbrand Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 297112 -01 Spanish Cross Cultur 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 08105!2009 (Cancelled)
Primary Instructor: Language Training Center
Class Location: Banquet Room C Class Dates: 09/16/2009 to 09/16/2009
Monon Center 6:OOP to 8:00P
W
Carmel, IN 46032 Scheduled Sessions: 1
(317848 -7275
Cancel Reason: low enrollment
CANCELLATION Refund Of 42.00
Enrollee Name: Charlotte Kaufman Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 297112 -01 Spanish Cross Cultur 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 09/09/2009 (Cancelled)
Page t
ACTIVITY REFUND RECEIPT
Receipt 342606
Payment Date: 10/06/2009
Household 29118
Primary Instructor: Language Training Center
Class Location: Banquet Room C Class Dates: 09/16/2009 to 09/16/2009
Monon Center 6:OOP to 8:00P
W
Carmel, IN 46032 Scheduled Sessions: 1
(317)848 -7275
Cancel Reason: low enrollment
GIL Code Description Account Number Cst Cntr Description Acco Number Am ount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 126.00 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 10/06/09 14:44:33 by MML FEES CHANGED ON CANCELLED ITEMS 126.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 126.00-
TOTAL'' AMOUNT REFUNDED,126:00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 126.00 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 of credit card refunds.
I 10k Irl" Tda�`Rn�_'r /C,)q
ut ri a Signal re ate Authorized Signature Date
4�, IiW52-o �wx
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.
Hildenbrand, John Terms
1035 Oswego Rd Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/6109 342606 Refund 126.00
Total 126.00
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.
Hildenbrand, John Allowed 20
1035 Oswego Rd
Carmel, IN 46032
In Sum of$
126.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
1
PO# or INVOICE NO. ACCT#TrITLE AMOUNT Board Members
Dept
1047 342606 4358400 126.00 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
126.00 Accounts Payable Coordinator_
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund