169081 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: T362569 Page 1 of 1
ONE CIVIC SQUARE DONNA MOWER
CARMEL, INDIANA 46032 10173 PAR] RIDGE PLACE CHECK AMOUNT: $42.00
CARMEL IN 46033
CHECK NUMBER: 169081
CHECK MATE: 211 712069
DEPARTMENT ACCO PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4358400 4358400 42.00 REFUNDS AWARDS INDE
i
I
-r
ACTIVITY REFUND RECEIPT
Receipt 224444
Payment Date: 0210212009"
Household 18223 FEB
Home Phone: (317)844 -6053 2009
Work Phone: (317)845 -2839
BY;
DONNA MOWER Monon Center
10173 PARTRIDGE PLACE Carmel IN 46032
CARMEL IN 46033
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 42.00
Enrollee Name: Carl Mower Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 397522 -01 Table Tennis League 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 01106120091 (Cancelled)
Primary Instructor: CCPR Staff
Class Location: Program Rms A, B, C Class Dates: 02/02/2009 to 04/20/2009
Monon Center 6:00P to 10:OOP
M
Carmel, IN 46032 Skip Days 03/09/2009
(317)848 -7275 Scheduled Sessions: 1 1
Cancel Reason: low enrollment
GIL Code_ Description Acc ount Numb Cst Cntr Description Account Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 42.00 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 02/02/09 14:20:30 by MML FEES CHANGED ON CANCELLED ITEMS 42.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
NET AMOUNT FROM CANCELLED ITEMS 42.00
TOTAL AMOUNT REFUNDED 42.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 42.00 Made By REFUND FINAN With Reference low enrollment
Page 1
ACTIVITY REFUND RECEIPT
Receipt 224444
Payment Date: 02/02/2009
Household 18223
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. �Q 2 G ►l t/ lo
i Authorized Signature Dat4 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.
Mower, Donna Terms
10173 Partridge Place Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
212109 224444 Refund 42.00
Total 42.00
1 hereby certify that the attached invoice(s), or bilf(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.
Mower, Donna Allowed 20
r 10173 Partridge Place
Carmel, IN 46033
In Sum of
42.00
r
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 224444 4358400 42.00 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
13 -Feb 2009
Signature
42.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund