170097 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: T362677 Page 1 of 1
1 ONE CIVIC SQUARE SCHUERMAN DORI CHECK AMOUNT: $44.00
CARMEL, INDIANA 46032 517 KENT LANE
CARMEL IN 46032 CHECK NUMBER: 170097
CHECK DATE: 3/18/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1046 4358400 44.00 PARKS DEPARTMENT REFU
C-4
ACTIVITY REFUND RECEIPT
Receipt 233311
Payment Date: 02/27/2009
Household 23185
Home Phone: (317)575 -9974'
Work Phone:
MAN d .1 2009
I
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 20.00
Enrollee Name- Lana Schuerman Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 486017 -04 Tumbling 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 02/26/2009 (Cancelled)
Class Location: Carmel Elem School Class Dates: 03/05/2009 to 03/26/2009
CarmelClayParksRec 2:45P to 3:45P
101 4th Avenue SE Th
Carmel, IN 46033
(317)848 -7275 S d Sessions: 4
Cancel Reason:
GIL Code Descri ption Ac count Num ber Cst Cntr Description Account_Number_ Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 44,00 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 CREDIT HOUSEHOLD BALANCE 24.00
Processed on 02/27/09 08:32:09 by JCM FEES CHANGED ON CANCELLED ITEMS 20.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
I NET AMOUNT FROM CANCELLED ITEMS 2D.00-
V V4 HH BALANCE APPLIED TO THIS RECEIPT 24.00
TOTAL AMOUNT REFUNDED 44.00
I NEW NET HOUSEHOLD BALANCE 0.00
r
Refund of =>%,_,44.00 Made By REFUND FINAN With Reference
Page 1
ACTIVITY REFUND RECEIPT
Receipt 233311
Payment Date: 02127/2009
Household 23185
Afl 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.
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.
Schuerman, Dori Terms
517 Kent Lane Date Due
Carmel, IN 46032
`1
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2127109 233311 Refund 44.00
Total 44.00
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
x I.. e
Voucher No. Warrant No.
Schuerman, Dori Allowed 20
517 Kent Lane
Carmel, IN 46032
In Sum of
44,00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 233311 4358400 44.00 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
44.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I