172907 05/27/2009 CITY OF (?ARMEL, INDIANA VENDOR: 362904 Page 1 of 1
ONE CIVIC SQUARE DIANE KOHAN
CARMEL, INDIANA 46032 213 BRIERLEY WAY CHECK AMOUNT: $6.00
CARMEL IN 46032
CHECK NUMBER: 172907
r CHECK DATE: 5/27/2009
DEPART ACCOUNT PO NUMBER INVOI NU MBER AMO UNT DESCRIPTION
1046 4358400 281419 6.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
,a
Receipt 261419
Payment Date: 05/19/2009 MAY 1
Household 265 s 1009
Home Phone: (317)848 -2328
Work Phone: (317)
DIANE KOHAN Carmel Elementary
213 BRIERLEY WAY 101 4th Avenue SE
CARMEL IN 46032 Carmel IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 6.00
Enrollee Name: Laurel Kohan Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 486019 -01 3 -13 Drawing 6.00 0.00 0.00 6.00 0.00
Enrollment Date: 03/06/2009 (Cancelled)
Class Location: Carmel Elem School Class Dates: 05/11/2009 to 05/18/2009
CarmelClayParksRec 2:45P to 3:45P
101 4th Avenue SE M
Carmel, IN 46033 Scheduled Sessions: 2
(317)848 -7275
Fee Details: Fee Description mount Count Discount Sales Tax Total Fee
3 -D Drawing 0 1.00 0.00 0.00 6.00
Cancel Reason: S gle Session C ed
G/L Code_ Description Account_ Number Description Account_ Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 6.00 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 05/19/09 08:32:00 by JCM FEES CHANGED ON CANCELLED ITEMS 12.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
G I SURCHARGE APPLIED AGAINST CANCELLED FEES 6.00
tt NET AMOUNT FROM CANCELLED ITEMS 6.00-
4 (��V� 1 n1 TOTAL AMOUNT REFUNDED 6.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 6.00 Made By REFUND FINAN With Reference
Page 1
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.
Kohan, Diane Terms
213 Brierley Way Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5119109 281419 Refund 6.00
Total 6.00
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.
Kohan, Diane Allowed 20
213 Brierley Way
rarmel, IN 46032
In Sum of
6.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 281419 4358400 6.00 1 hereby certify that the attached invoice(s), or
bi!I(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
6.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund