211396 07/31/2012 CITY OF CARMEL, INDIANA VENDOR: 366431 Page 1 of 1
ONE CIVIC SQUARE JEFF NEWKIRK
CHECK AMOUNT: $240.00
CARMEL, INDIANA 46032 111 BENNETT RD
CARMEL IN 46032 CHECK NUMBER: 211396
CHECK DATE: 7/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 910537 70 . 00 REFUNDS AWARDS & INDE
1096 4358400 912091 170 . 00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
rme Clay
tB 07/2 Receipt# 37
Payment Date: 07/23/12
Household #: 39084
Parks&Recreation
Monon Community Center Jeff Newkirk Hm Ph: (317)529-8510
Carmel IN 46032 111 Bennett Rd Wk Ph: (317)837-5949
Carmel IN 46032 Cell Ph:
sandraieff.newkirk @yahoo.com
Phone: (317)848-7275
Fed Tax ID #35-6000972
Enrollment Details
CANCELLATION - Refund Of 70.00
Enrollee Name: Edvards Newkirk Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 126105-01 First Fencers 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 06/28/2012 (Cancelled)
Primary Instructor: Jeanne Slain
Class Location: Program Rms B&C Class Dates: 07/18/2012 to 08/08/2012
Monon Community Cntr 6:OOP to 6:45P
W
Carmel, IN 46032 Scheduled Sessions: 4
(317)848-7275
Cancel Reason: advanced request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/23/12 @ 11:32:01 by LVA FEES CHANGED ON CANCELLED ITEMS(+) 70.00-
NET AMOUNT FROM CANCELLED ITEMS 70.00-
TOTAL AMOUNT REFUNDED 70.00
NEW NET CREDIT HOUSEHOLD BALANCE 42.50
Refund of=_> 70.00 Made By==>REFUND FINAN With Reference==>advanced request
All refunds are subject to State Board of Accounts claim procedure and may take 4-6 weeks to process. A check will be
issu . No cash or credit card refunds.
-7 12 3 V3/m
Authorized Sigd ure Date I 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:H2011 cprv.theregistrationsystem.com/en/l033!
DAY PASSES ARE NON-REFUNDABLE
cue r Page# 1 of 1
ACTIVITY REFUND RECEIPT
Receipt# 912091
Carmel l v flay Payment Date: 07/24/12
,y
Parts&Recreatio' n Household #: 39084
Monon Community Center Jeff Newkirk Hm Ph: (317)529-8510
Carmel IN 46032 _ 111 Bennett Rd Wk Ph: (317)837-5949
R�F F`" r b ° Carmel IN 46032 Cell Ph:
T r-
I sandrajeff.newkirk @yahoo.com
Phone: (317)848-7275
Fed Tax ID #35-6000972 JUL 2 5 2012 i
Enrollment Details
CANCELLATION - Refund Of 85.00
Enrollee Name: Jake Newkirk Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 126106-01 Fencing 1 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 06/01/2012 (Cancelled)
Primary Instructor: Jeanne Slain
Class Location: Program Rms B&C Class Dates: 07/16/2012 to 08/06/2012
Monon Community Cntr 6:OOP to 7:OOP
M
Carmel, IN 46032 Scheduled Sessions: 4
(317)848-7275
Cancel Reason: advanced request
CANCELLATION - Refund Of 85.00
Enrollee Name: Zack Newkirk Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 126106-01 Fencing 1 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 06/01/2012 (Cancelled)
Primary Instructor: Jeanne Slain
Class Location: Program Rms B&C Class Dates: 07/16/2012 to 08/06/2012
Monon Community Cntr 6:OOP to 7:OOP
M
Carmel, IN 46032 Scheduled Sessions: 4
(317)848-7275
Cancel Reason: advanced request
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/24/12 @ 15:21:32 by LVA FEES CHANGED ON CANCELLED ITEMS(+) 170.00-
NET AMOUNT FROM CANCELLED ITEMS 170.00-
TOTAL AMOUNT REFUNDED 170.00
NEW NET CREDIT HOUSEHOLD BALANCE 42.50
Refund of=_> 170.00 Made By=_>REFUND FINAN With Reference=_>advanced request
All refunds are subject to State Board of Accounts claim procedure and may take we s to process. A check will be
issue . No cash or credit card refunds.
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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.
Terms
Newkirk, Jeff Date Due
111 Bennett Rd
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/23/12 910537 Refund $ 70.00
7/24/12 912091 Refund $ 170.00
Total $ 240.00
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
120
Clerk-Treasurer
Voucher No. Warrant No.
Allowed 20
Newkirk, Jeff
111 Bennett Rd
Carmel, IN 46032 In,Sum of$
$ 240.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-42 910537 4358400 $ 70.00 1 hereby certify that the attached invoice(s), or
1096-42 912091 4358400 $ 170.00 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
26-Jul 2012
Signature
$ 240.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund