175168 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 363075 Page 1 of 1
j ONE CIVIC SQUARE MATT TANNER CHECK AMOUNT: $118.00
G CARMEL, INDIANA 46032 4620 BUCKINGHAM COURT
CARMEL IN 46033 CHECK NUMBER: 175168
an
CHECK DATE: 7/22/2009
DEPARTMENT A CCOUNT PO NUMB INVOICE NUMBER A MOUNT DES
1047 4358400 118.00 56
ACTIVITY REFUND RECEIPT
r
Receipt 292053
Payment Date: 07/0112009 C A e JUL 0 7
Household 17370Qa9
Horne Phone: (317)816 -0611
Work Phone:
MATT TANNER Monon Center
4620 BUCKINGHAM CT Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
Enrollee Name_ Daniel Tanner Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 195002 -02 Lil' Dragon Taekwo 45.00 O.DO 0.00 45.00 0.00
Enrollment Date: 07/01/2009 (Enrolled Transfer from 196372 -02 (Dancing Little Star))
Primary Instructor: Indy Taekwondo
Class Location. Gymnasium C Class Dates: 07/09/2009 to 08/27/2009
Monon Center 4:OOP to 4:30P
Th
Carmel, IN 46032 Scheduled Sessions: 8
(317)848 -7275
Fee Details: Fee Description _,____Amount Count Discount Sales Tax ___Total_Fee
Indy Tae Kwon Do Lit 45.00 1.00 0.00 0.00 45.00
G/L Code Description Account Number Csl Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 118.00 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 38.00
Processed on 07/01/09 13:10:30 by LVA FEES ADJUSTED ON CHANGED ITEMS 80.00
DISCOUNT APPLIED AGAINST THESE FEES 0.00
NET FROM/TO TRANSFER TAX 0.00
NET AMOUNT FROM CHANGED ITEMS 80.00
HH BALANCE APPLIED TO THIS RECEIPT 38.00-
TOTAL AMOUNT REFUNDED 118.00
NEW NET HOUSEHOLD BALANCE 0.00
Page 1
ACTIVITY REFUND RECEIPT
Receipt 292053
Payment Date: 07/01/2009
Household 17370
oa
Refund of 118.00 Made By REFUND FINAN With Reference low enrollment
Payment of 45.00 Made By Activity Registration Credit Balance
Rewards Points refunded on this receipt: 4.50
Household Reward Point Balance: 68.70
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.
Authorized Sign re Date f Authorized Signature Date
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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.
s Payee Purchase Order No.
Tanner, Matt Terms
4620 Buckingham Ct Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
711/09 292053 Refund 118.00
Total 118.00
k hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with is 5- 11- 10 -1.6
1 20
Clerk- Treasurer
J
Voucher No. Warrant No.
Tanner, Matt Allowed 20
4620 Buckingham Ct
Carmel, IN 46033
In Sum of
118.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1047 292053 4358400 118.00 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
16 -Jul 2009
Signature
118.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund