173023 05/27/2009 5e.oyr CITY OF CARMEL, INDIANA VENDOR: T362677 Page 1 of 1
Q ONE CIVIC SQUARE SCHUERMAN DORI CHECK AMOUNT: $6.00
CARMEL, INDIANA 46032 517 KENT LANE
CARMEL IN 46032 CHECK NUMBER: 173023
CHECK DATE: 5127/2009
DEPA RTMENT ACCOUNT �PO NUMBER IN VOICE NUMBER AMOU DESCRIPTI
10 46 4358400 261407 6.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 261407
Payment Date: 05/19/2009 a
Household 23185 MAY 1 9 2009
Home Phone: (317)575 -9974
Work Phone:
II:.......................
DORI SCHUERMAN Carmel Elementary
517 KENT LANE 101 4th Avenue SE
CARMEL IN 46032 Carmel IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 6.00
Enrollee Name: Lana SChuerman Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 486019-01 3 -D Drawing 6.00 0.00 0.00 6.00 0.00
Enrollment Date: 02/26/2009 (Cancelled)
Class Location: Carmel Elem School Class Dates: 05/11/2009 to 05/18/2009
CarmelClayParksRec 2:45P to 3:45P
101 4th Avenue SE M
Carmel, IN 46033 Scheduled Sessions: 2
(317)848 -7275
Fee Details: Fee Description___._.__... Amount _Count, D_ iscount Sales Tax Total Fee,
3 -D Drawing 6.00 1.00 0.00 0.00 6.00
Cancel Reason. ngle Session Cancelled
GIL 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 6.00 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 05/19(09 08:22:52 by JCM FEES CHANGED ON CANCELLED ITEMS 12.00-
0 DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 6.00
NET AMOUNT FROM CANCELLED ITEMS 6.00-
�I V V �U 0 TOTAL AMOUNT REFUNDED fi.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 6.00 Made By REFUND FINAN With Reference
Page 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.
Schuerman, Dori Terms
Date Due
517 Kent Lane
Carmel, IN 46032
Invoice Invoice Description
Date Number
or note attached invoice 6.00
s) or bill(s)) Amount
Da
5119109 261407 Refund
Total 6.00
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.
Schuerman, Dori Allowed 20
517 Kent Lane
Carmel, IN 46032
In Sum of
6.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 261407 4358400 6.00 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
21 -May 2009
Signature
6.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund