174016 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 362973 Page 1 of 1
b ONE CIVIC SQUARE CASSIN REITER
CARMEL, INDIANA 46032 13434 PENNINGER DRIVE CHECK AMOUNT: $150.00
WESTFIELDIN 46074 CHECK NUMBER: 174016
;mss,
CHECK DATE: 6124/2009
D_.EP ARTMENT ACCOUNT PO NUMBER INVO NUMBER A MOUNT DESCRIPTION
1046 4558400 150.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
C"
Receipt# 268717'
Payment Date: 06/04/2009
Houbehold 11847 r JUN 0 8 2009
Home Phone: (317)733 -0285
Work Phone: (317)492 -9166
11y:
CASSIN REITER Monon Center
13434 PENNIGER DR. Carmel IN 46032
WESTFIELD IN 46074
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 37.50
Enrollee Name. Lauren Reiter Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476001 -26. Vacation Station 37.50 0.00 37.50 0.00 0.00
Enrollment Date: 02/04/2009 (Cancelled)
Class Location: West Clay Elementary Class Dates. 07/06/2009 to 07/10/2009
West Clay Elementary 7:OOA to 6:OOP
3495 W. 126th St. M,Tu,W,Th,F
Carmel, IN 46032 Scheduled Sessions: 5
(317)844 -9961
Fee Details: Fee Description Amount Count Discount. Sales Tax Tota Fee
Vacation Station Res 37.50 1.00 0.00 0.00 37.50
Cancel Reason: ChedUle Conflict
CANCELLATION Refund Of 37.50
Enrollee Name: Lauren Reiter Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476001 -27 Vacation Station 37.50 0.00 37.50 0.00 0.00
Enrollment Date: 02104/2009 (Cancelled)
Class Location: West Clay Elementary Class Dates: 07/1312009 to 07/17/2009
West Clay Elementary 7:OOA to 5:00P
3495 W. 126th St. M,Tu,W,Th,F
Carmel, IN 46032 Scheduled Sessions: 5
(317)844 -9961
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Vacation Station Res 37.50 1.00 0.00 0.00 37.50
Cancel Reason: schedule conflict
CANCELLATION Refund Of 37.50
Enrollee Name: Lauren Reiter Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476001 -28 Vacation Station 37.50 0.00 37.50 0.00 0.00
Enrollment Date: 02/04/2009 (Cancelled)
4(0 21 D 01 Page #1
ACTIVITY REFUND RECEIPT
Receipt 268717
Payment Date: 06/0412009
Household 11847
Class Location: West Clay Elementary Class Dates: 07/20/2009 to 07/24/2009
West Clay Elementary 7:OOA to 6:OOP
3495 W. 126th St. M,Tu,W,Th,F
Carmel, IN 46032 Scheduled Sessions: 5
(317)844 -9961
Fee Details. Fee Descri Amount C ount Discount Sales T ax Total Fee
Vacation Station Res 37.50 1.00 0.00 0.00 37.50
Cancel Reason: schedule conflict
CANCELLATION Refund Of 37.50
Enrollee Name: Lauren Reiter Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476001 -29 Vacation Station 37.50 0.00 37.50 0.00 0.00
Enrollment Date: 02104/2009 (Cancelled)
Class Location: West Clay Elementary Class Dates: 07/27/2009 to 07/31/2009
West Clay Elementary 7:00A to 6:OOP
3495 W. 126th St. M,Tu,W,Th,F
Carmel IN 46032 Scheduled Sessions: 5
(317)844 -9961
Fee Details: Fee Descr Amount Count_ Discount Sales Tax Total Fee
Vacation Station Res 37.50 1.00 0.00 0.00 37.50
Cancel Reason: schedule conflict
G/L Code Description Account Number Cst Cntr Description Account Number Amoun
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 150.00 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 06 /04/09 10:27:45 by BJJ FEES CHANGED ON CANCELLED ITEMS 150.00
DISCOUNT APPLIED AGAINST CANCELLED FEES O 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NETIAMOUNT:FROM CANCELLED,tITEMS 150]0
TOTAL AMOUNT REFUNDED 1'S0�00:
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 150.00 Made By REFUND FINAN With Reference
All refunds are )ect to State Board of Accounts claim procedure and may take 4 -6 weeks to process (A che:ck)MIl be
issued. No cash or credit card refunds.
Page 2
ACTIVITY REFUND RECEIPT
Receipt 268717
Payment Date: 06/04/2009
Household 11847
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A thorize gnature Date Authorized Signature Date
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Page 3
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.
Reiter, Cassin Terms
13434 Penniger Dr Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
614109 268717 Refund 150.00
Total 150.00
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
Voucher No. Warrant No.
Reiter, Cassin Allowed 20
13434 Penniger Dr
Westfield, IN 45074
In Sum of
150.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#MTLE AMOUNT Board Members
Dept
1046 268717 4358400 150.00 I 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
18 -Jun 2009
Signature
150.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund