172024 04/29/2009 CITY OF CARMEN, INDIANA VENDOR: T362676 Page 1 of 1
ONE CIVIC SQUARE SALENTINE THOMAS
CHECK AMOUNT: $21.00
CARMEL, INDIANA 46032 2980 KINGS COURT
CARMEL IN 46032 CHECK NUMBER: 172024
CHECK DATE: 4129/2009
DEPARTMENT ACCOUNT PO NU MBER INVO NUMBER W AMOUNT DESCRIPTION
1047 4358400 246688 21.00 REFUNDS AWARDS INDE
ik
r
M
ACTIVITY REFUND RECEIPT
Receipt 246688
Payment Date: 04/10/2009 ^7
Household 5861
Home Phone: (317)733 -4343
Work Phone: I APR 6 2009
THOMAS SALENTINE Monon Center
2980 KINGS COURT Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 21.00
Enrollee Name: Jane Salentine Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 397353 -01 Power Over Paper 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 12/1912008 (Cancelled)
Primary Instructor: Janet Nusbaum
Class Location: Program Room A Class Dates: 04/14/2009 to 04/14/2009
Monon Center 6:30P to 7:45P
Tu
Carmel, IN 46032 Scheduled Sessions: 1
(317)848 -7275
Cancel Reason: low enrollment
GI Code Description Account Number Cst Cn Descrip Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 21.00 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 04/10/09 10.40:38 by MML FEES CHANGED ON CANCELLED ITEMS 21.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 21.00
TOTAL AMOUNT REFUNDED 2500
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 21.00 Made By REFUND FINAN With Reference
Page 9 1
ACTIVITY REFUND RECEIPT
Receipt 246688
Payment Date: 04/10/2009
Household 5861
All refunds re subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. a or dit c refunds.
4 a, 1 P n� L1 1�{ 09
Authorized Signature Authorized Signature Hate
Page 2
ACTIVITY REFUND RECEIPT
psi
Rrceipt 24668$
Payment Date: 04/10/2009 P zQQ�
Household 5861
Home Phone: (317)733 -4343 .BYc
Work Phone:
THOMAS SALENTINE Monon Center
2980 KINGS COURT Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 21.00
Enrollee Name: Jane Salentine Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 397353 -01 Power Over Paper 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 12/19/2008 (Cancelled)
Primary Instructor: Janet Nusbaum
Class Location: Program Room A Class Dates: 04/14/2009 to 04/14/2009
Monon Center 6:30P to 7:45P
Tu
Carmel, IN 46032 Scheduled Sessions: 1
(317)848 -7275
Cancel Reason: low enrollment
G/ 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 21.00 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 04/10/09 10.40:38 by MML FEES CHANGED ON CANCELLED ITEMS 21.00
DISCOUNT APPLIED AGAINST CANCELLED FEES O 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
:NET AMOUNT FROM CANCELLED ITEMS 21.00-
'TOTAL AMOUNT REFUNDED 21.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 21.00 Made By REFUND FINAN With Reference
Page 1
ACTIVITY REFUND RECEIPT
Receipt 246688
Payment Date: 04/10/2009
Household M. 5861
All refunds re subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issued. a or dit c refunds.
A l uthorized Signature 7 Eatle A Signature Date
400 L 3 X 35 R qW /*-t ed
1lo� 5
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.
Salentine, Thomas Terms
2980 Kings Court Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4110/09 246688 Refund 21.00
Total 21.00
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.
Salentine, Thomas Allowed 20
2980 Kings Court
Carmel, IN 46032
In Sum of
21.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1047 246688 4358400 21.00 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 -Apr 2009
Signature
21.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund