175943 08/06/2009 CITY OF CARMEL, INDIANA VENDOR: 363204 Page 1 of 1
x4 e1 ONE CIVIC SQUARE SVETLANA VARKONYI CHECK AMOUNT: $55.00
CARMEL, INDIANA 46032 7037 LIEBER ROAD
INDIANAPOLIS IN 46260 CHECK NUMBER: 175943
CHECK DATE: 8/612009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DE SCRIPTION
1047 4358400 312348 55.00 REFUNDS AWARDS INDE
f�
ACTIVITY REFUND RECEIPT
Receipt 312348
Payment Date: 07/30/2009
Household 20971
Home Phone: (317)255 -0313
Work Phone: (317)
i�
JUL 3 1 2009
SVETLANA VARKONYI Monon Center
7837 LIEBER RD Carmel IN 46032
INDIANAPOLIS IN 46260
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 55.00
Enrollee Name: Lara Varkonyi Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 195121 -04 Mom -N -Me Gymnastics 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 07/28/2009 (Cancelled)
Primary Instructor: Tumble Time
Class Location: Gymnasium C Class Dates: 08/04/2009 to 08125/2009
Monon Center 10:30A to 11:OOA
Tu
Carmel, IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: low enrollment
G Code Description Account Number_ Cst Cntr Description Acc_o_unt 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 07(3DI09 14:50:41 by LVA 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 55.00-
TOTAL 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 312348
Payment Date: 07/30/2009
Household 20971
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issu o cash or credit card refunds.
Authorized Sig ure Date Authorized Signature Date
MIA
Page 4 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.
Varkonyi, Svetlana Terms
7837 Lieber Rd Date Due
Indianapolis, IN 46260
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7130109 312348 Refund 55.00
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.
Varkonyi, Svetlana Allowed 20
7837 Lieber Rd
Indianapolis, IN 46260
In Sum of
a 55.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1047 31234 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
31 -Jul 2009
Signature
55.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund