167797 01/20/2009 CITY OF CARMEL, INDIANA VENDOR: T362369 Page 1 of 1
ONE CIVIC SQUARE KAY YOKOTA
It CARMEL, INDIANA 46032 1434 CAREY ST CHECK AMOUNT: $49.00
CARMEL IN 46032 CHECK NUMBER: 167797
roa a
CHECK DATE: 1/20/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 215958 .49.00 REFUNDS AWARDS INDE
t.' d
ACTIVITY REFUND RECEIPT
Receipt 215958
Payment Date: 01/07/2009
Household 3768
Home Phone: (317)575 -9167
Work Phone:
.JAN 2 2009
KAY YOKOTA Monon Center
1434 CAREY CT Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax I D #35- 6000972
Enrollment Details
Enrollee Name: Amy Yokota Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 394319 -01 Amazing Abs 16.00 0.00 0.00 16.00 0.00
Enrollment Date: 01107/2009 (Enrolled Transfer from 394317 -01 (Cross Trainer))
Primary Instructor: CCPR Staff
Class Location: Dance Studio Class Dates: 01/05/2009 to 01/26/2009
Monon Center 5:30P to 5:55P
M
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 4
Fee Details: Fee Description A mount C ount Discount Sales T ax Total Fee
Amazing Ab 16.00 1.00 0.00 0.00 16.00
Enrollee Name: Amy Yokota Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 394319 -03 Amazing Abs 16.00 0.00 0.00 16.00 0.00
Enrollment Date: 01107/2009 (Enrolled Transfer from 394317 -05 (Cross Trainer))
Primary Instructor: CCPR Staff
Class Location: Dance Studio Class Dates: 02/02/2009 to 02/23/2009
Monon Center 5:30P to 5:55P
Carmel, IN 46032 M
(317)848 -7275 Scheduled Sessions: 4
Fee Details: Fee Description Amount Count Discount S ales Tax Total F ee
Amazing Ab 16.00 1.00 0.00 0.00 16.00
Page 1
ACTIVITY REFUND RECEIPT
Receipt 215958
Payment Date: 01/07/2009
Household 3768
Enrollee Name: Amy Yokota Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number. 394319 -05 Amazing Abs 20.00 0.00 0.00 20.00 0.00
Enrollment Date: 01/07/2009 (Enrolled Transfer from 394317 -09 (Cross Trainer))
Primary Instructor: CCPR Staff
Class Location: Dance Studio Class Dates: 03102/2009 to 03/30/2009
Monon Center 5:30P to 5:55P
Carmel, IN 46032 M
(317)848 -7275 Scheduled Sessions: 5
Fee Details: Fee Descri Count Discount Sal Tax Total Fee
Amazing Ab 20.00 1.00 0.00 0.00 20.00
Enrollee Name: Amy Yokota Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 394319 -07 Amazing Abs 12.00 0.00 0.00 12.00 0.00
Enrollment Date: 01/07/2009 (Enrolled Transfer from 394317 -13 (Cross Trainer))
Primary Instructor: CCPR Staff
Class Location: Dance Studio Class Dates: 04/13/2009 to 04/27/2009
Monon Center 5:30P to 5:55P
M
Carmel, IN 46032 Skip Days 04/06/2009
(317)848 -7275 Scheduled Sessions: 3
Fee Details: Fee Des Amount Discount Sales T ax Total Fee
Amazing Ab 12.00 1.00 0.00 0.00 12.00
G/L Code Descri Account Num Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 49.00 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 01 /07 /09 16:09:09 by CEK FEES ADJUSTED ON CHANGED ITEMS 49.00
DISCOUNT APPLIED AGAINST THESE FEES 0.00
NET FROM/TO TRANSFER TAX 0.00
NET AMQUNT,?F,ROM CHANGED:ITEMS 49:00=
TOTAL,AMOUNTREFUNDED '49'00')
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 49.00 Made By REFUND FINAN With Reference cls transfer diff
Page 2
ACTIVITY REFUND RECEIPT.
Receipt 215958
Payment Date: 09/07/2009
Household 3768
Payment of 64.00 Made. By Activity Registration Credit Balance
Rewards Points refunded on this receipt: 6.40
Household Reward Point Balance: 35.20
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.
00.z.t.tQ� r r
Authorized Signature Date Authorized Signature bate
y 7, 3 q D. 3 u,J. ql 35 q crj
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.
Yokota, Kay Terms
1434 Carey Ct Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/7/09 215958 Refund 49.00
Total 49.00
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.
Yokota, Kay Allowed 20
1434 Carey Ct
Carmei, IN 46032
In Sum of
49.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1047 215958 4358400 49.00 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
15 -Jan 2009
Signature
49.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund