169219 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: T361264 Page 1 of 1
ONE CIVIC SQUARE WILLIAM ZEH CHECK AMOUNT: $15.00
CARMEL, INDIANA 46032 13735 FOUR SEASONS WAY
WESTFIELD IN 46074 CHECK NUMBER: 169219
CHECK DATE: 2/17/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 225355 15.00 REFTJNDS.AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 225355
Payment Date: 02/05/2009
Household 4563
Home Phone: (317)733 -1338
Work Phone: FFR 1 1 2009
i
WILLIAM ZEH Monon Center
13735 FOUR SEASONS WAY Carmel IN 46032
WESTFIELD IN 46074
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
I
Enrollment Details
CANCELLATION Refund Of 15.00
Enrollee Name: Jonathan Zeh Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 396455 -01 CoEd Teen Dodgebal 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 01/26/2009 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Gymnasium C Class Dates: 02/08/2009 to 03/29/2009
Monon Center 1:OOP to 2:30P
Su
Carmel, IN 46032 Skip Days 02/22/2009
(317)848 -7275 Scheduled Sessions: 7
Cancel Reason: love enrollment
G/L Code Description Account Number Cst Cntr Description Account Number Amo
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 15.00 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 02/05(09 16:50:28 by LVA FEES CHANGED ON CANCELLED ITEMS 15.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 15,00-
TOTAL AMOUNT REFUNDED 15.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 15.00 Made By REFUND FINAN With Reference low enrollment
Page 1
ACTIVITY REFUND RECEIPT
Receipt 225355
Payment Date: 02/05/2009
Household 4563
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 Sign re Date Authorized Signature Date
q7. y00 q,)-O. L] ?voo
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.
Zeh, William Terms
13735 Four Seasons Way Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/5/09 225355 Refund 15.00
Total 15.00
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.
Zeh, William Allowed 20
13735 Four Seasons Way
Westfield, IN 46074
In Sum of
15.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT#fTITLE AMOUNT Board Members
Dept
1047 225355 4358400 15.00 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
13 -Feb 2009
Signature
15.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund