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Home My WebLink About172422 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 362851 Page 1 of 1 ONE CIVIC SQUARE CHARLOTTE LIPPERT CHECK AMOUNT: $525.00 CARMEL, INDIANA 46032 12785 FORSYTH ST CARMEL IN 46032 CHECK NUMBER: 172422 CHECK DATE: 5/13/2009 DEP ARTMENT ACCOUN PO NUMBER INV NUMBER A MOUNT DESCRIPTION 1046 4358400 253995 525..00 REFUNDS AWARDS INDE 4 ACTIVITY REFUND RECEIPT Receipt 253995 Q 3 g Payment Date: 04/29/2009 Household 16816 A P R 2 9 2009 Home Phone: (317)519 -7421 Work Phone: BY: CHARLOTTE LIPPERT West Clay Elementary 12785 FORSYTH ST 3495 W. 126th St. CARMEL IN 46032 Carmel IN 46032 Phone: (317)844 -9961 Fed Tax ID #35- 6000972 Enrollment Details CANCELLATION Refund Of 75.00 Enrollee Name: Claire Weems Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476001 -21 Vacation Station 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 02/10/2009 (Cancelled) Class Location: West Clay Elementary Class Dates: 06/01/2009 to 06/05/2009 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 Cancel Reason: Job loss CANCELLATION Refund Of 75.00 Enrollee Name: Claire Weems Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476001 -22 Vacation Station 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 02/10/2009 (Cancelled) Class Location: West Clay Elementary Class Dates: 06/08/2009 to 06/12/2009 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 Cancel Reason: Job loss CANCELLATION Refund Of 75.00 Enrollee Name: Claire Weems Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476001 -23 Vacation Station 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 02/10/2009 (Cancelled) Page 1 ACTIVITY REFUND RECEIPT Receipt 253995 Payment Date: 04/29/2009 Household 16816 Class Location: West Clay Elementary Class Dates: 06/15/2009 to 06/19/2009 West Clay Elementary 7:OOA to 6:OOP 3495 W. 126th St. M,Tu,Th,F Carmel, IN 46032 Scheduled Sessions: 4 (317)844 -9961 Cancel Reason: job loss CANCELLATION Refund Of 75.00 Enrollee Name: Claire Weems Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476001 -24 Vacation Station 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 02110/2009 (Cancelled) Class Location: West Clay Elementary Class Dates: 06/22/2009 to 06/26/2009 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 Cancel Reason: job loss CANCELLATION Refund Of 75.00 Enrollee Name: Claire Weems Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476001 -25 Vacation Station 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 02/10 /2009 (Cancelled) Class Location: West Clay Elementary Class Dates: 06/29/2009 to 07/03/2009 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 Cancel Reason: job loss CANCELLATION Refund Of 75.00 Enrollee Name: Claire Weems Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476001 -27 Vacation Station 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 02/10/2009 (Cancelled) Class Location: West Clay Elementary Class Dates: 07/13/2009 to 07/17/2009 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 Cancel Reason: job loss Page 2 ACTIVITY REFUND RECEIPT Receipt 253995 Payment Date: 04/29/2009 Household 16816 CANCELLATION Refund Of 75.00 Enrollee Name: Claire Weems Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 476001 -28 Vacation Station 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 02/10/2009 (Cancelled) 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 Cancel Reason: job loss G/L Code Description___ Account Numbe Cnlr_ Description_____ Account Number ___Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 525.00 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 524.00 Processed on 04/29/09 12:41:15 by JLH FEES CHANGED ON CANCELLED ITEMS 1,050.00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00 SALES TAX CHARGED ON CANCELLED FEES 0.00 NET AMOUNT FROM CANCELLED ITEMS 1,050.00- 525.00 HH BALANCE APPLIED TO THIS RECEIPT 525.00 TOTAL AMOUNT REFUNDED NEW NET CREDIT HOUSEHOLD BALANCE 1.00 Refund of 525.00 Made By REFUND FINAN With Reference All e unds e subject to State Board of Accou fs claim procedure and may take 4 -6 weeks to process. A check will be tss ed. N c sh or credit C d ref n r1 V U Date Date Authorized Signature Aut ri e igna e I I' CP UN� �Y Pag 3 i c y 4:.. 1 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. Lippert, Charlotte Terms 12785 Forsyth St Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 4129/09 253995 Refund 525.00 Total 525.00 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. Lippert, Charlotte Allowed 20 12785 Forsyth St Carmel, IN 46032 In Sum of 525.00. ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1046 253995 4358400 525.00 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 7 -May 2009 Signature 525.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund