169238 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: T360444 Page 1 of 1
ONE CIVIC SQUARE JESSICA MASON CHECK AMOUNT: $126.00
CARMEL, INDIANA 46032 13800 SPRINGMILL BLVD
CARMEL IN 46032 CHECK NUMBER: 169238
CHECK DATE: 2/17/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 223058 116.00 REFUNDS AWARDS INDE
1047 4358400 223118 10.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Payment 223 =BY:
Pa ment Date: 01!29/2009 9/2009
Household 8176
H
F RE E
ome Phone: (317)566 -0896
Work Phone:
JESSICA MASON Monon Center
13800 SPRINGMILL BLVD Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 10.00
Enroifee Name: Oliver Mason Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number. 395277 -01 Games Galore 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 12/02/2008 (Cancelled)
Primary instructor: CCPR Staff
Class Location: Gymnasium C Class Dates: 02/02/2009 to 02/23/2009
Monon Center 2 :OOP to 2 :30P
M
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 4
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 10.00 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 01/29/09 16:33:10 by CNA FEES CHANGED ON CANCELLED ITEMS 10.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 10.00
TOTAL AMOUNT REFUNDED 10.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 10.00 Made By REFUND FINAN With Reference low enrollment
Page 1
ACTIVITY REFUND RECEIPT
Receipt 223118
Payment Date: 01/29/2009
Household 8176
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.
Pnkf 9
A thorized Signature Date Authorized Signature Date
H 00. �5 -3 0 y 35 3q 00
Page 2
ACTIVITY REFUND RECEIPT
Receipt 223058
Payment Date: 01/29/2009
Household 8176 FEB 0 9 2009
Home Phone: (317)566 -0896
Work Phone: BY-
JESSICA MASON Monon Center
13800 SPRINGMILL BLVD Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 51.00
Enrollee Name: Oliver Mason Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 393003 -09 Guppy 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 12/02/2008 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Indr Leisure Pool 3 Class Dates: 01/12/2009 to 02/11/2009
Monon Center 4:15P to 4:45P
M,W
Carmel, IN 46032 Skip Days 01/01/2009
(317)848 -7275 Scheduled Sessions: 10
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Guppy Level 1 (Youth 7.00 1.00 0.00 0.00 7.00
Cancel Reason: Parent has a time conflict with this class
CANCELLATION Refund Of 65.00
Enrollee Name: Oliver Mason Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 393003 -14 Guppy 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 12/02/2008 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Indr Leisure Pool 3 Class Dates: 02/23/2009 to 03/25/2009
Monon Center 4:15P to 4:45P
M,W
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 10
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Guppy Level 1 (Youth 7.00 1.00 0.00 0.00 7.00
Cancel Reason: Parent has a time conflict with this class
Page 1
ACTIVITY REFUND RECEIPT
Receipt 223058
Payment Date: 01/29/2009
Household 8176
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 116.00 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 01/29/09 12:57:44 by ALC FEES CHANGED ON CANCELLED ITEMS 130.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 14.00
NET. 'AMOUNT-- FROM,cANCELLED'IT.EMS 1';16 00=>
;TOTAL=AMOUNT:`REF.UNDED i1i16 00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 116.00 Made By REFUND FINAN With Reference
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.
1 1 7, 01
Authorized Signature Date Authorized Signature Date
60
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.
Mason, Jessica Terms
13800 Spring Mill Blvd Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/29/09 223118 Refund 10.00
1/29/09 223058 Refund 116.00
Total 126.00
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.
Mason, Jessica Allowed 20
13800 Spring Mill Blvd
Carmel, IN 46032
In Sum of
126.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 223118 4358400 10.00. 1 hereby certify that the attached invoice(s), or
1047 223058 4358400 116.00 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
126.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund