209706 06/05/2012 CITY OF CARMEL, INDIANA VENDOR: 366287 Page 1 of 1
ONE CIVIC SQUARE LYNN ZARVAS CHECK AMOUNT: $200.00
CARMEL, INDIANA 46032 2977 WINTERSET DR
CARMEL IN 46032 CHECK NUMBER: 209706
CHECK DATE: 6/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 200.00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt 830218
me l Payment Date: 05/25/12
Household 35204
arks&:R(�Creedon
_f ED
Monon Community Center Lynn Zarvas Hm Ph: (317)733 -1277
Carmel IN 46032 2977 Winterset Drive Wk Ph: (317)846 -7331
JUN 012012 Carmel IN 46032 Cell Ph: (317)418 -6666
Lzarvas @ccs.k12.in.us
Phone: (317)848 -7275 i
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 200.00
Enrollee Name: Rosie Thompson Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 123023 -02 Lifeguarding 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 04/22/2012 (Cancelled)
Class Location: Pool Observation Rm Class Dates: 07/17/2012 to 07/20/2012
Monon Community Cntr 9:OOA to 6:OOP
Tu,W,Th,F
Carmel IN 46032 Scheduled Sessions: 4
(317)848 -7275
Cancel Reason: Will re- enroll using HH credit.
PREVIOUS NET CREDIT HOUSEHOLD BALANCE 175.00
Processed on 05/25/12 08:20:04 by LWW FEES CHANGED ON CANCELLED ITEMS 200.00
`;NET;,AMOUNT %;FROM CANCELLED�ITEMS. ,,200?00-
TOTAL AMOUNT REFUNDED 'W�= 4 F200.00
t NEW NET CREDIT HOUSEHOLD BALANCE 175.00
Refund of 200.00 Made By REFUND FINAN With Reference Check refund
All refunds are subject to State Board of Accounts claim procedure and may o process. A check will be
issued. No cash or credit card refunds. eek
WAfjQ.&J 6.26. �T /z
Authorized Signature Date ignatur Date
Volunteer with Us!
Volunteers are the foundation of Carmel Clay Parks Recreation and we need your help! We are currently seeking volunteers
for special events, adaptive programs, parks and greenways, and Extended School Enrichment. If interested, please call Dana
at 317.843.3868 or register online at https: //2011 cpry .theregistrationsystem.com /en /1033!
DAY PASSES ARE NON REFUNDABLE R
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Page 1 of 1
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.
Terms
Zarvas, Lynn Date Due
2977 Winterset Drive
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/25/12 830218 Refund 200.00
Total 200.00
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.
Allowed 20
Zarvas, Lynn
2977 Winterset Drive
Carmel, IN 46032 In Sum of
200.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 -10 830218 4358400 200.00 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
1 -Jun 2012
UW YQrr'V
Signature
200.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund