178758 10/28/2009 CITY OF CARMEL, INDIANA VENDOR: 363450 Page 1 of 1
i ONE CIVIC SQUARE MELINDA LACKEY CHECK AMOUNT: $128.00
o CARMEL, INDIANA 46032 14845 JONATHAN DR
WESTFIELDIN 46074 CHECK NUMBER: 178758
CHECK DATE: 10/28/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 344624 128.00 REFUNDS AWARDS INDE
r,
ACTIVITY REFUND RECEIPT
a
Receipt 344624
Payment Date: 10/14/2009 9 �J
Household 29478
Home Phone: (317)663 -4732 OCT 2 0 2009
Work Phone: (317)379 -6752
Ly.
MELINDA LACKEY Monon Center
14845 JONATHAN DR. Carmel IN 46032
WESTFIELD IN 46074
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 59.00
Enrollee Name: Emmett Lackey Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 295296 -02 Hear See -Touch -Read 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 08107/2009 (Cancelled)
Primary Instructor: Fun2Learn
Class Location: Program Room C Class Dates: 10/21/2009 to 11/25/2009
Monon Center 9:OOA to 9:45A
W
Carmel, IN 46032 Scheduled Sessions: 6
(317)848 7275
Cancel Reason: low enrollment
CANCELLATION Refund Of 69.00
Enrollee Name: Emmett Lackey Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 295297 -02 Science Factory Jr. 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 09108/2009 (Cancelled)
Primary Instructor: Fun2Learn
Class Location: Program Room C Class Dates: 10/21/2009 to 11/25/2009
Monon Center 10:OOA to 10:45A
W
Carmel, IN 46032 Scheduled Sessions: 6
(317)848 -7275
Cancel Reason: low enrollment
G/L Code Description Account Number Cst C ntr Descri Account Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 128.00 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.
Page 1
r ACTIVITY REFUND RECEIPT
Receipt 344624
Payment Date: 10/14/2009
Household 29478
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 10/14/09 09:24:23 by CNA FEES CHANGED ON CANCELLED ITEMS 128.00-
DISCOUNT APPLIED AGAINST CANCELLED FEES O 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 128.00
TOTAL AMOUNT REFUNDED 128.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 128.00 Made By REFUND FINAN With Reference low enrollment
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.
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Autho ized Signature Date Authorized Signature Date
qT y 00.330. q3q 0� Oo
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.
Lackey, Melinda Terms
14845 Jonathan Dr Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/14/09 344624 Refund 128.00
Total 128.00
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.
Lackey, Melinda Allowed 20
14845 Jonathan Dr
Westfield, IN 46074
In Sum of
is 128.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #1TITLE AMOUNT Board Members
Dept
1047 344624 4358400 128.00 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
22 -Oct 2009
Signature
128.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund