167783 01/20/2009 CITY OF CARMEL, INDIANA VENDOR: T362360 Page 1 of 1
ONE CIVIC SQUARE ANN JOHNSTON CHECK AMOUNT: $64.00
CARMEL, INDIANA 46032 5149 ORIOLE DR
CARMEL IN 46033 CHECK NUMBER: 167783
CHECK DATE: 1/20/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 213794 64.00 REFUNDS AWARDS INDE
r
ACTIVITY REFUND RECEIPT
Receipt 213794
Payment Date: 12/31/2008
Household 23736
Home Phone: (317)816 -1439
Work Phone:
ANN JOHNSTON 1 Monon Center
5149 ORIOLE DR. Carmel IN 46032
CARMEL IN 46033 ,JAN 0 7 2009
Phone: (317)848 -7275
J
7 Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 64.00
Enrollee Name: Ann Johnston Fees Tax Discount Prey Paid Cur Paid Amount Due
Activity Number: 397366 -01 Tap 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 12/22/2008 (Cancelled)
Primary Instructor: Dance Class Studio
Class Location: Dance Class Studio Class Dates: 01/08/2009 to 02/26/2009
Dance Class Studio 10:45A to 11:30A
260 W. Carmel Drive Th
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 8
Cancel Reason: low enrollment
G/L Code Description Account Number Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 64.00 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 12/31/08 13:29:24 by CNA FEES CHANGED ON CANCELLED ITEMS 64.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS
TOTAL AMOUNT AMOUNT REFUNDED 64.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 64.00 Made By REFUND FINAN With Reference low enrollment
Page 1
ACTIVITY REFUND RECEIPT
Receipt 213794
Payment Date: 12/31/2008
Household M 23736
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.
1"c �ndtx I L�Ice
Authorized Signature Date Authorized Signature Date
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.
Johnston, Ann Terms
5)4q Driole Dr Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/31/08 213794 Refund 64.00
Total 64.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
Johnston, Ann Allowed 20
51 49+ Oriole Dr
Carmel, IN 46033
In Sum of$
64.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1047 213794 4358400 64.00 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
15 -Jan 2009
Signature
64.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund