167796 01/20/2009 CITY OF CARMEL, INDIANA VENDOR: T362368 Page 1 of 1
ONE CIVIC SQUARE DICK TRIPPETT
D CHECK AMOUNT: $15.00
CARMEL, INDIANA 46032 3aascouENrRVWAY
CARMEL IN 46033 CHECK NUMBER: 167796
CHECK DATE: 1/20/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT ..DESCRIPTION
1047 4358400 216139 15.00 REFUNDS AWARDS INDE
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ACTIVITY REFUND RECEIPT
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Receipt 216139
Payment Date: 01/08/2009 JAN j 2009
Household 18963
Home Phone: (317)844 -5815 i
Work Phone:
DICK TRIPPETT Monon Center
3845 COVENTRY WAY Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 15.00
Enrollee Name: Dick Trippett Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 397013 -01 Senior Wii Games 0.00 0.00 0.00 a -00 0.00
Enrollment Date: 12/15/2008 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Program Room A Class Dates: 01115/2009 to 03/05/2009
Monon Center 1:00P to 3:OOP
Th
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 8
Cancel Reason: low enrollment
G/L Code Description Account N Cst Cntr Descri Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 15.00 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 01/08/09 14:49:56 by MML FEES CHANGED ON CANCELLED ITEMS 15.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET'AMOUNT FROM CANCELLED ITEMS 15.00
TOTAL AMOUNT REFUNDED 15A0
NEW NET HOUSEHOLD BALANCE L L 0.00
Refund of 15 -00 Made By REFUND FINAN With Reference low enrollment
Page 1
ACTIVITY REFUND RECEIPT
Receipt 216139
Payment Date: 0110812009
Household 18963
All s s c to State bard counts laim pr cedure and may take 4 -6 weeks to process. A check will be
as u d No s c dit car fund
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A o z n ture ale Authorized Signature Date
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.
Payee
Purchase Order No.
Trippett, Dick Terms
3845 Couentry Way Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
118109 216139 Refund 15.00
Total 15.00
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,
Trippett, Dick Allowed 20
3845 Couentry Way
Carmel, IN 46033
In Sum of$
15.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or Board Members
Dept INVOICE NO. ACCT#ITITLE AMOUNT
1047 216139 4358400 15.00 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
4
Signature
15.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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