172957 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: T362674 Page 1 of 1
ONE CIVIC SQUARE NELSON SUSAN CHECK AMOUNT: $12.00
CARMEL, INDIANA 46032 2 HILDA COURT
ti, CARMEL IN 46032 CHECK NUMBER: 172957
CHECK DATE: 5/27/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUM AMOUNT. DESCRIPTION
1046 4358400 261408 12.00 REFUNDS AWARDS INDE
6
R
ACTIVITY REFUND RECEIPT
Receipt 261408
Payment Date: 05/19/2009
Household 7414
Home Phone: (317)569 -0343
Work Phone: (317)224 -4619 L MAY 1 9 2009 i
DL'
SUSAN NELSON Carmel Elementary
TWO HILDA CT. 101 4th Avenue SE
CARMEL IN 46032 Carmel IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 12.00
Enrollee Name: JOSie Nelson Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 486019 -01 3 -D Drawing 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 04/01/2009 (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
Cancel Reason: CE2lass cancelled /child was sick
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 12.00 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 08:24:22 by JCM FEES CHANGED ON CANCELLED ITEMS 12.00-
O DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
II 'I 1 1 I�1 NET AMOUNT FROM CANCELLED ITEMS 12.00
O`er TOTAL AMOUNT REFUNDED 12.00
V 1 VU NEW NET HOUSEHOLD BALANCE 0.00
Refund of 12.00 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
issued. No cash or credit card refunds.
Page 1
q ACCOUNTS PAYABLE VOUCHER
f 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.
Nelson, Susan Terms
Two Hilda Ct. Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/19/09 261408 Refund 12.00
Total I 12.00
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
N
Voucher No. Warrant No.
Nelson, Susan Allowed 20
Tw® Hilda Ct.
Carmel, IN 46032
In Sum of
12.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 261408 4358400 12.00 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
21 -May 2009
Signature
12.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund