175798 08/06/2009 a CITY OF CARMEL, INDIANA VENDOR: 363203 Page 1 of 1
ONE CIVIC SQUARE KIM MCSHAY
CARMEL, INDIANA 46032 13440 KINGSBURY DRIVE CHECK AMOUNT: $52.00
CARMEL IN 46032
CHECK NUMBER: 175798
CHECK DATE: 816/2009
DEPARTMENT ACCOUNT PO NUM INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 312337 52.00 REFUNDS AWARDS INDE
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ACTIVITY REFUND RECEIPT
u
Receipt 312337
Payment Date: 07/30/2009 JU
3 U
Household 27543 1 X009
Home Phone: (317)694 -3292
Work Phone:
U g
KIM MCSHAY Monon Center
13440 KINGSBURY DR JUL 3 1 2009 Carmel IN 46032
CARMEL IN 46032
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 52.00
Enrollee Name: Kelsey McShay Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 196368 -04 Cheerleading 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 07/14/2009 (Cancelled)
Primary Instructor: Tumble Time
Class Location: Party Rooms A B Class Dates: 08/05/2009 to 08/26/2009
Monon Center 5:OOP to 5:45P
W
Carmel IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: low enrollment
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 52.00 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 07/30/09 14:41:12 by LVA FEES CHANGED ON CANCELLED ITEMS 52.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 52.00-
TOTAL AMOUNT REFUNDED 52.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 52.00 Made By REFUND FINAN With Reference low enrollment
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ACTIVITY REFUND RECEIPT
Receipt 312337
Payment Date: 07/30/2009
Household 27543
All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be
issue o cash or credit card refunds.
Authorized Si ture 11ate f Authorized Signature Date
L O W
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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.
McShay, Kim Terms
13440 Kingsbury Dr Date Due
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/30/09 312337 Refund 52.00
Total 52.00
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
1 20
Clerk- Treasurer
Voucher No. Warrant No.
McShay, Kim Allowed 20
13440 Kingsbury Dr
Ki Carmel, IN 46032
In Sum of
52.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 312337 4358400 52.00 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
31 -Jul 2009
Signature
52.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund