170093 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: T362676 Page 1 of 1
ONE CIVIC SQUARE SALENTINE THOMAS
0 3' CHECK AMOUNT: $67.00
CARMEL, INDIANA 46032 2980 KINGS COURT
CARMEL IN 46032 CHECK NUMBER: 170093
CHECK DATE: 3/18/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AM OUNT DESCRIPTION
1047 4358400. W 67.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt 235586
Payment Date: 03/05/2009
Household 5861 MAR 1 9 2009
Home Phone: (317)733 -4343
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 67.00
Enrollee Name: Samuel Salentine Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 396335 -01 Click? Beginning Pho 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 12/19/2008 (Cancelled)
Primary Instructor: CCPR Staff
Class Location- Art Studio Class Dates: 03/10/2009 to 03/31/2009
Monon Center 4:OOP to 5:OOP
Tu
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 4
Cancel Reason: low enrollment
G/L C ode Description Account Number Cst Cntr De Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 67.00 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 03/05/09 15:16:09 by LVA FEES CHANGED ON CANCELLED ITEMS 67.00
DISCOUNT APPLIED AGAINST CANCELLED FEES O 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 67.00
TOTAL AMOUNT REFUNDED 67.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 67.00 Made By REFUND FINAN With Reference low enrollment
Page 1
ACTIVITY REFUND RECEIPT
Receipt 235586
Payment Date: 03/05/2009
Household 5861
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.
r
Authorized nature D to Authorized Signature Date
im M,,f d l to
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
315109 235586 Refund 67.00
Total 67.00
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.
Salentine, Thomas Allowed 20
2980 Kings Court
Carmel, IN 46032
In Sum of$
67.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1047 235586 4358400 67.00 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
12 -Mar 2009
Signature
67.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund