174394 07/08/2009 CITY OF CARMEL, INDIANA VENDOR: T361497 Page 1 of 1
ONE CIVIC SQUARE JENNIFER KING
CHECK AMOUNT: $143.00
CARMEL, INDIANA 46032 13361 KICKAP00 TRAIL
L,. CARMEL IN 46033 CHECK NUMBER: 174394
CHECK DATE: 718/2009
DE PARTME NT ACCOUNT PO NUMB INVOICE NUMBER AMOUNT DESCRIPTION
1046 4358400 143.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt 290691
Payment Date: 06/29/2009
Household 17804
Home Phone: (317)580 -0374 JUL 0 2 2009
Work Phone: (317)255 -4900
JENNIFER KING Monon Center
13361 KICKAPOO TRAIL Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 143.00
Enrollee Name: Lauren King Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476001 -07 Vacation Station 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 04/20/2009 (Cancelled)
Class Location: Cherry Tree Elem Sch Class Dates: 07/13/2009 to 07/17/2009
Cherry Tree Elementa 7:OOA to 6:OOP
13869 Hazel Dell Road M,Tu,W,Th,F
Carmel, IN 46033 Scheduled Sessions: 5
(317)848 -7275
Fee Details: Fee Description Amount Count Dis count Sales Tax Total Fee
Vacation Station Res 7.00 1.00 0.00 0.00 7.00
Cancel Reason: r schedule conflic
I_
G/L Code Description Account Number Cst Cntr Descri Acc ount Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 143.00 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 06/29/09 11:44:59 by BJJ FEES CHANGED ON CANCELLED ITEMS 150.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 7.00
NET AMOUNT FROM CANCELLED ITEMS 143.00
TOTAL AMOUNT REFUNDED 'L 143.00
NEW NET HOUSEHOLD BALANCE CSC 1 0.00
Refund of 143.00 Made By REFU' D FINA N With Reference 4 -,9 J O o O i
Page 1
ACTIVITY REFUND RECEIPT
Receipt# 290691
Payment Date: 06/29/2009
Household 17804
All refund re subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. check ill be
issued. N cash or credit card refunds. -7-1
A horiz ignature Date Authorized Signature Date
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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.
King, Jennifer Terms
13361 kickapoo Trail Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6129109 290691 Refund 143.00
Total 143.00
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.
King, Jennifer Allowed 20
13361 kickapoo Trail
Carmel, IN 46033
In Sum of
143.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 290691 4358400 143.00 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
2 -Jul 2009
Signature
143.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund