174987 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: T360158 Page 1 of 1
ONE CIVIC SQUARE MICHELLE LEE CHECK AMOUNT: $13.50
`o CARMEL, INDIANA 46032 5865 SANDALWOOD DR
}oe 2� CARMEL IN 46032 CHECK NUMBER: 174987
CHECK DATE: 7/22/2009
DEPARTMENT ACCOUNT PO N UMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 290583 13.50 PARKS DEPARTMENT REFU
M
ACTIVITY REFUND RECEIPT
Receipt 290583
Payment Date: 06/29/2009
Household 5439
Home Phone: (317)848 -0114
Work Phone: (317)848 -0114
MICHELLE LEE Monon Center
5865 SANDALWOOD DR. Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
ROSTER CHANGE Refund Of 7.00
Enrollee Name: Jason Lee Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 193006 -19 Polliwog Level 1 45.00 0.00 45.00 0.00 0.00
Enrollment Date: 06/29/2009 (Enrolled)
Class Location: Outdr Lap Pool 1 Class Dates: 06/29/2009 to 07/09/2009
Monon Center 9:45A to 10:15A
M,Tu,W,Th
Carmel, IN 46032 Scheduled Sessions: 8
(317)848 -7275
Fee Details: Fee Descri Amount Count dis S Tax _Total, Fee
Guppy Level 1 (Youth 45.00 1.00 0.00 0.00 45.00
G/L Cod Descri Account Number Cst Cntr Description Accou Num Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 13.50 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 CREDIT HOUSEHOLD BALANCE 6.50
Processed on 06/29/09 10:31:15 by ALC FEES ADJUSTED ON CHANGED ITEMS 7.00
DISCOUNT APPLIED AGAINST THESE FEES O 0.00
SALES TAX CHARGED ON CHANGED FEES 0.00
NET AMOUNT FROM CHANGED ITEMS 7:00
HH BALANCE APPLIED TO THIS RECEIPT 6.50
TOTAL AMOUNT REFUNDED 13.50
NEW NET HOUSEHOLD BALANCE 0.00
Page 1
ACTIVITY REFUND RECEIPT
Receipt 290583
Payment Date: 06/29/2009
Household 5439
Refund of 13.50 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.
i Authorized Signature Date Authorized Signature Date
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.
Lee, Michelle Terms
5865 Sandalwood Dr Date Due
Carmel, IN 46032
I
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6129109 290583 Refund 13.50
Total 13.50
E 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.
Lee, Michelle Allowed 20
5865 Sandalwood Dr
Carmel, IN 46032
1y In Sum of
13.50
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 290583 4358400 13.50 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
20 -Jul 2009
Signature
13.50 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund