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179409 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 363560 Page 1 of 1 ONE CIVIC SQUARE BRENDA SHIPP CARMEL, INDIANA 46032 3596 INVERNESS BLVD CHECK AMOUNT: $112.00 CARMEL IN 46032 CHECK NUMBER: 179409 CHECK DATE: 11/11/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1047 4358400 349371 112.00 REFUNDS AWARDS INDE ACTIVITY REFUND RECEIPT Receipt 349371 Payment Date: 10/29/09 Household 31393 Morton Center Brenda Shipp Hm Ph: (317)334 -1620 Carmel IN 46032 3596 Inverness Blvd Carmel IN 46032 Cell Ph: brendakshipp@yahoo.com Phone: (317)848 -7275 Fed Tax ID #35- 6000972 Enrollment Details CANCELLATION Refund Of 112.00 Enrollee Name: Brenda Shipp Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 297423 -01 Piano 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 10/2112009 (Cancelled) Primary Instructor: Impromptu Music Class Location: Program Room A Class Dates: 10/27/2009 to 12/08/2009 Monon Center 7:30P to 8:30P F Carmel, IN 46032 Scheduled Sessions: 6 (317)848 -7275 Skip Days 11/24/2009 1 NOV 0 2 2009 Cancel Reason: low enrollment 0 G/L Code Descri Account Number Cst Cntr Descrip Account Numb Amount 999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 112.00 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 10129/09 11:3429 by MML FEES CHANGED ON CANCELLED ITEMS 112.00 NET AMOUNT FROM ITEMS TOTAL AMOUNT AMOUNT REFUNDED 112:00 NEW NET HOUSEHOLD BALANCE 0.00 Refund of 112.00 Made By REFUND FINAN With Reference low enrollment All refunds are s bject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be issued. o or ciedit card refunds. Authorize Signature Da (e Authorized Signature Date 7. qd0. 52 3 D 00 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. Shipp, Brenda Terms 3596 Inverness Blvd Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 10/29/09 349371 Refund 112.00 Total 112.00 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 -1.5 ,20 Clerk- Treasurer Voucher No. Warrant No. Shipp, Brenda Allowed 20 3596 Inverness Blvd Carmel, IN 46032 In Sum of !tir 112.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1047 349371 4358400 112.00 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 5 -Nov 2009 Signature 112.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund