169563 03/04/2009 CITY OF CARMEL, INDIANA VENDOR: 362600 Page 1 of 1
ONE CIVIC SQUARE LILLIAN OUIMETTE
`f CARMEL, INDIANA 46032 10907 THUNDERBIRD DR CHECK AMOUNT: $55.00
CARMEL IN 46032
CHECK NUMBER: 169563
CHECK DATE: 3/4/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 232164 55.00 REFUNDS AWARDS INDE
i
i
ACTIVITY REFUND RECEIPT
r
Receipt 232164.0
7 FEB a Payment Date: 02/23/2009 I'. Household 2612
Home Phone: (317)582 -0339 2 5 2009
Work Phone:
B Y:
LILLIAN OUIMETTE Monon Center
10907 THUNDERBIRD DR. Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 55.00
Enrollee Name: Lucas Ouimette Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 395145 -03 Start Smart Sport De 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 01/05/2009 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Gymnasium C Class Dates: 02/25/2009 to 04/01/2009
Monon Center 1:001P to 2:OOP
W
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 6
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 55.00 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 02/23/09 14:02:34 by CNA FEES CHANGED ON CANCELLED ITEMS 55.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS' TOTAL AMOUNT AMOUNT REFUNDED 55.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 55.00 Made By REFUND FINAN With Reference low enrollment
Page 1
ACTIVITY REFUND RECEIPT
Receipt 232164
Payment Date: 0212312009
Household 2612
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.
Auth rized 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.
Terms
Ouimette, Lillian
10907 Thunderbird Dr Date Due
Carmel, IN 46032
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
55.00
2123109 232164 Refund
Total 55.00
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.
Ouimette, Lillian Allowed 20
10907 Thunderbird Dr
Carmel, IN 46032
In Sum of
4
55.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #ITITL AMOUNT Board Members
Dept
1047 232164 4358400 55.00 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
26 -Feb 2009
Signature
55.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund