HomeMy WebLinkAbout210263 07/05/2012 CITY OF CARMEL, INDIANA VENDOR: 366323 Page 1 of 1
ONE CIVIC SQUARE DEANNE BACHTOLD
0 CHECK AMOUNT: $158.00
CARMEL, INDIANA 46032 10556 TRADERS PASS
r ;off BROWNSBURG IN 46112 CHECK NUMBER: 210263
CHECK DATE: 7/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1082 4358400 158.00 REFUNDS AWARDS INDE
ACTIVITY REFUND RECEIPT
Receipt 865366
Carmel 0 Clay Payment Date: 06/21/12
Household 40361
Part sAecreed
Monon Community Center =2201Z DeAnne Bachtold Hm Ph: (317)694 -2675
Carmel IN 46032 10556 Traders Pass Wk Ph: (317)569 -6176
Brownsburg IN 46112 Cell Ph:(317)694 -2675
bachtold2 @comcast.net
Phone: (317)848 -7275 Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 158.00
Enrollee Name: Cale Bachtold Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476004 -05 Chiliville 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 01/07/2012 (Cancelled)
Class Location: Pool Observation Rm Class Dates: 06/25/2012 to 06/29/2012
Monon Community Cntr 8:30A to 5:30P
M,Tu,W,Th,F
Carmel IN 46032 Scheduled Sessions: 5
(311
Cancel Reason: schedule conflict
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 06/21/12 14:42:51 by BJJ FEES CHANGED ON CANCELLED ITEMS 165.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 7.00
NET AMOUNT -FROM CANCELLED`:ITEMS _A 58. 0
TOTALAMOUNT,REFUNDED 158:00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of 158.00 Made By EFUND FINAN With Reference 1082- 9- 4358400✓e 1�
All refunds are subject to State counts claim procedure and may take weeks to process. A check will be
issued. 7ash or credit card refunds.
1 -1
Au on ignature Date Authorized Signature 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
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.
Bachtold, DeAnne Terms
10556 Traders Pass Date Due
Brownsburg, IN 46112
Invoice Invoice Description
Date Number (or note attached invoices) or bill(s)) Amount
6/21/12 865366 Refund 158.00
Total 158.00
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.
Bachtold, DeAnne Allowed 20
10556 Traders Pass
Brownsburg, IN 46112
In Sum of
158.00
I
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1082 -9 865366 4358400 158.00 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
28 -Jun 2012
Signature
158.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund