168612 02/04/2009 CITY OF CARMEL, INDIANA VENDOR: 362476 Page 1 of 1
0 ONE CIVIC SQUARE JOHN MODRALL CHECK AMOUNT: $58.00
CARMEL, INDIANA 46032 5328 MAE DRIVE
CARMEL IN 46033 CHECK NUMBER: 168612
CHECK DATE: 2/4/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 58.00 PARKS DEPARTMENT REFU
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ACTIVITY REFUND RECEIPT
Receipt 161066
Payment Date: 07/24/2008
Household 10924
Home Phone: (317)706 -0350
Work Phone:
JOHN MODRALL Monon Center
5328 MAE DRIVE Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 58.00
Enrollee Name: Caroline Modrall Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 183004 -10 Minnow 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 05/19/2008 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Indoor Lap Pool 1 Class Dates: 07/21/2008 to 07/31/2008
Monon Center 9:15A to 9:45A
M,Tu,W,Th
Carmel, IN 46032
(317)848 -7275 Scheduled Sessions: 8
Fee Details: Fee Description Amount Count Discount Sales Tax Total Fee
Minnow Resident 7.00 1.00 0.00 0.00 7.00
Cancel Reason: Class was too easy for child and could not coordinate next level to schedule AC
G/L 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 58.00 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 07/24/08 15:24:59 by ALC FEES CHANGED ON CANCELLED ITEMS 65.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 7.00
'NET AMOUNT °F.:ROM�CANCELLED�ITEMS 58 00=
TOTAL AMOUNT REFUNDED__ 58:00
NEW NET HOUSEHOLD BALANCE 0.00
Page 1
ACTIVITY REFUND RECEIPT
Receipt 161066
Payment Date: 07/24/08
Household 10924
Refund of 58.00 Made By REFUND FINAN With Reference
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.
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Authorized O nature Date 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.
Payee
Purchase Order No.
Modrall, John Terms
5328 Mae Drive Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7124108 161066 Refund 58.00
Total 58.00
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.
Modrall, John Allowed 20
5328 Mae Drive
Carmel, IN 46033
In Sum of
58.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT WTITLE AMOUNT Board Members
Dept
1047 161066 4358400 58.00 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
2 -Feb 2009
Signature
58.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund