170035 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: T357073 Page 1 of 1
ONE CIVIC SQUARE FUMIKA NONAKA
CARMEL, INDIANA 46032 3868 CORNWALLIS LANE CHECK AMOUNT: $80.00
CARMEL IN 46032 CHECK NUMBER: 170035
CHECK DATE: 311612009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 80.00 REFUNDS AWARDS INDE
I
ACTIVITY REFUND RECEIPT
r
Receipt 235053 c
Payment Date: 03/03/2009
Household 14686
Home Phone: (317)733 -2160 L MAR 1, 2 2009
Work Phone: (317)
FUMIKA NONAKA Monon Center
3868 CORNWALLIS LANE Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 80.00
Enrollee Name: Juri Nonaka Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 395116 -02 Baby Yoga 0.00 0.00 0_00 0.00 0.00
Enrollment Date: 12/09/2008 (Cancelled)
Primary Instructor: Tumble Time
Class Location: Fitness Studio A Class Dates: 03/10/2009 to 04/28/2009
Monon Center 9:30A to 10:15A
Tu
Carmel, IN 46032 Skip Days 04/07/2009
(317)848 -7275 Scheduled Sessions: 7
Cancel Reason: class was cancelled due to low enrollment
GIL 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 80.00 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 03103/09 15:10:50 by SLR FEES CHANGED ON CANCELLED ITEMS 80.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0 -00
NET AMOUNT FROM CANCELLED ITEMS..80.00-
TOTAL AMOUNT "REFUNDEI] SQAO.
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 80.00 Made By REFUND FINAN With Reference check refund
Page 1
ACTIVITY REFUND RECEIPT
Receipt 235053
Payment Date: 03/03/2009
Household 14686
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 Signatu Date Authorized Signature Date
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Page 2
ACCOUNTS PAYABLE VOUCHER
or w 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.
Nonaka, Furnika Terms
3868 Cornwallis Lane Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
313109 235053 Refund 80.00
Total 80.00
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.
Nonaka, Fumika Allowed 20
3868 Cornwallis Lane
Carmel, IN 46032
In Sum of
80.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #rrITLE AMOUNT Board Members
Dept
1047 235053 4358400 80.00 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
12 -Mar 2009
Signature
80.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund