179289 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 363553 Page 1 of 1
ONE CIVIC SQUARE ANNE KORNAFEL
CHECK AMOUNT: $10.00
CARMEL, INDIANA 46032 9968 KOVEY CT
INDIANAPOLIS IN 46280 CHECK NUMBER: 179289
CHECK DATE: 11/11/2009
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
t
1 047 4358400 349968 10.00 REFUNDS AWARDS INDE
Y
ACTIVITY REFUND RECEIPT
Receipt 349968
Payment Date: 10/31/09
Household 5955
Monon Center Anne Kornafel Hm Ph: (317) 91 -9026
Carmel IN 46032 9968 Kovey Ct Wk Ph: (317)803 -0034
Indianapolis IN 46280 Cell Ph: (317)919-0268
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
Enrollee Name: Anne Kornafel Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 294410 -03 Tai Chi 12.00 0.00 0.00 12.00 0.00
Enrollment Date: 10131/2009 (Enrolled -Transfer from 294392 -12 (Aqua Ai Chi))
Primary Instructor: CCPR Staff
Class Location: Fitness Studio A Class Dates: 11/04/2009 to 11/18/2009
Monon Center 8:OOP to 9:50P
W
Carmel, IN 46032 Scheduled Sessions: 3
(317)848 -7275
Skip Days 11/25/2009
G/L Code Descri Account Number C st Cntr Descri Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 10.00 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 10/31/09 13:38:30 by TCP FEES ADJUSTED ON CHANGED ITEMS 10.00
NET AMOUNT FROM CHANGED ITEMS 10.00.
TOTAL AMOUNT REFUNDED 10.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 10.00 Made By REFUND FINAN With Reference transfer of class
Payment of 12.00 Made By Activity Registration Credit Balance NOV q 2009 N V 2
Rewards Points refunded on this receipt: 1.20
Household Reward Point Balance: 9.00
BY
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.
Authorized Signature Date Authorized Signature Date
Page 1
r
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.
Kornafel, Anne Terms
9968 Kovey Ct Date Due
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/4/29 349968 Refund 10.00
Total 10.00
I 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.
Kornafel, Anne Allowed 20
9968 Kovey Ct
Indianapolis, IN 46280
In Sum of
10.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 349968 4358400 10.00 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
5 -Nov 2009
Signature
10.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund