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167794 01/20/2009 CITY OF CARMEL, INDIANA VENDOR: T361506 Page 1 of 1 ONE CIVIC SQUARE VIKRAM SINHA CHECK AMOUNT: $55.00 +l CARMEL, INDIANA 46032 3713 SHAFER CR CARMEL IN 46033 CHECK NUMBER: 167794 CHECK DATE: 1/20/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1047 4358400 215986 55.00 REFUNDS AWARDS INDE P%%& 1 1511 11 I1G r LIImL/ 1\G5✓GIr I i Receipt 215986 Payment Date: 01/07/2009 Household 11106 Home Phone: (317)571 -8749 Work Phone: JAN 1 2 Z00� VIKRAM SINHA Monon Center 3713 SHAFER CIRCLE Carmel IN 46032 CARMEL IN 46033 Phone: (317)848-7275 Fed Tax ID #35- 6000972 Enrollment Details CANCELLATION Refund Of 55.00 Enrollee Name: Ahana Sinha Fees Tax Discount Prey Paid Cur Paid Amon t D ue Activity Number 395145 -01 Start Smart Sport De 0.00 0.00 0.00 0.00 0.00 Enrollment Date: 12/23/2008 (Cancelled) Primary Instructor: CCPR Staff Class Location: Gymnasium C Class Dates: 01/14/2009 to 02/18/2009 Monon Center 1:OOP to 2:OOP W Carmel, IN 46032 (317)848 -7275 Scheduled Sessions: 6 Cancel Reason: low enrollment 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 55.00 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 01/07/09 17:20:39 by CNA FEES CHANGED ON CANCELLED ITEMS 55.00 DISCOUNT APPLIED AGAINST CANCELLED FEES 0,00 SALES TAX CHARGED ON CANCELLED FEES 0.00 NET AMOUNT FROM CANCELLED ITEMS TOTAL AMOUNT AMOUNT REFUNDED NEW NET HOUSEHOLD BALANCE Refund of 55.00 Made By REFUND FINAN With Reference Clow nrollment Page 1 ACTIVITY REFUND RECEIPT Receipt 275986 Payment Date: 01/07/2009 Household 11106 All refunds are subject to State Board of Accounts claim procedure and may take 4-6 weeks to process. check be issued. No cash or credit card refunds. :fdL go E C( Authorized Signature Date Authorized Signature Date Page 2 y -�)SG Soo. y358y (�dr +s) CA 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. Sinha, Vikram Terms 3713 Shafer Circle Date Due Carmel, IN 46033 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 117109 215986 Refund 55.00 Total 55.00 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. Sinha, Vikram Allowed 20 3713 Shafer Circle Carmel, IN 46033 In Sum of 55.00 ON ACCOUNT OF APPROPRIATION FOR 104 Program Fund PO# or INVOICE NO. ACCT #/TlTLE AMOUNT Board Members Dept 1047 215986 4358400 55.00 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 15 -Jan 2009 Signature 55.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund