170241 03/31/2009 CITY OF CARMEL, INDIANA VENDOR: T362692 Page 1 of 1
ONE CIVIC SQUARE MARISA KELLEY
CARMEL, INDIANA 46032 12010 WINNERS CIRCLE CHECK AMOUNT: $40.00
CARMEL IN 46032 CHECK NUMBER: 170241
CHECK DATE: 3/31/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4358400 241113 40.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 241113
Payment Date: 03/19/2009
Z77 1 r,—
Household 22661 FI
Home Phone: (317)733 -9960 MAR 0 2009
Work Phone: (317)
MARISA KELLEY West Clay Elementary
12010 WINNERS CIRCLE 3495 W. 126th St.
CARMEL IN 46032 Carmel IN 46032
Phone: (317)844 -9961
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 20.00
Enrollee Name: Daniellea Kelley Fees Tax Discount Prey Paid Cur Paid Amount Due
Activity Number: 486109 -03 Cartooning 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 02/23/2009 (Cancelled)
Class Location: West Clay Elementary Class Dates: 05/06/2009 to 05/27/2009
West Clay Elementary 2:45P to 3:45P
3495 W. 126th St. W
Carmel, IN 46032
(317)844 -9961 Scheduled Sessions: 4
CANCELLATION Refund Of 20.00
Enrollee Name: Christina Kelley Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 486109 -03 Cartooning 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 02/23/2009 (Cancelled)
Class Location: West Clay Elementary Class Dates: 05/06/2009 to 05/27/2009
West Clay Elementary 2:45P to 3:45P
3495 W. 126th St. W
Carmel, IN 46032
(317)844 -9961 Scheduled Sessions: 4
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 40.00 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.
Page 1
ACTIVITY REFUND RECEIPT
Receipt 241113
Payment Date: 03/19/2009
Household 22661
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 03/19/09 18:18:23 by JLH FEES CHANGED ON CANCELLED ITEMS 40.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 40.00
TOTAL AMOUNT REFUNDED 40.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 40.00 Made By REFUND FINAN With Reference
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issr No c �h or credit rd r nd
1
Ault ri d nature Date Authorized Signature Date
L�A ti
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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.
Kelley, Marisa Terms
12010 Winners Circle Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/19/09 241113 Refund 40.00
Total I 40.00
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.
Kelley, Marisa Allowed 20
12010 Winners Circle
Carmel, IN 46032
In Sum of
40.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 241113 4358400 40.00 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
25 -Mar 2009
Signature
40.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund