214639 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 366714 Page 1 of 1
ONE CIVIC SQUARE ELIZABETH FRANK CHECK AMOUNT: $25.00
CARMEL, INDIANA 46032 757 EDEN WOODS PLACE
�• o�.� CARMEL IN 46033 CHECK NUMBER: 214639
CHECK DATE: 11/2012012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 25 . 00 REFUND
ACTIVITY REFUND RECEIPT
Receipt# 966585
I Payment Date: 11/05/12 ;._'
Household#: 14872 '
ih.
Monon Community Center 1L-T'- C�-` (N'7'F.,D Elizabeth Frank Hm Ph: (-317)844-667.1}
Carmel IN 46032 757 Eden Woods Place
NOV 0 7 2012 Carmel IN 46033 Cell Ph:
Fesfrank@aol.com
(317)848-7275 ,f:s >
n .
Fed Tax ID#35-6000972 ' -' # r=.
Enrollment Details
CANCELLATION -Refund Of 25.00
Enrollee Name: Elizabeth Frank Fees+Tax Discount Prev Paid Cur Paid'f'Amount Due
Activity Number: 224500-02 On the Trail to Fitn 0.00 0.00 0.00 0.00?`.'k%'. i 0:00
Enrollment Date: 11/02/2012 (Cancelled) '" "`
..fir
Class L=ocation: No Room Needed Class Dates: 11/07/2012 to 12/19/2012
Monon Community Cntr 10:OOA to 11:OOA
W _''
Carmel, IN 46032 Scheduled Sessions: 6
(317)848-7275 ° ~
Skip Days 11/21/2012
Cancel Reason: Low enrollment
PREVIOUS NET HOUSEHOLD BALANCE
•r_gcr_ j; ;0.00
Processed on 11/05/12 @ 15:02:20 by LWW FEES CHANGED ON CANCELLED ITEMS(+) '? " 25:00-
NET'AMOUNT FROM CANCELLED.ITEMS`�'�_',n17
TOTAL AMOUNT REFUNDEDf,:' ";;'25'.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 25.00 Made By=_>REFUND FINAN With Reference=_>Check refund
All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds',*' ill be '.
issued.
12
Au ized Signature Date Authoriz d Si ure Date
2 2
EYG 1 1 Spen d a relaxing evening taking a walk through the winter n Saturday, December 1,from�;6,-9pn . ;
Enjoy carolers and hot chocolate as you take in the ambiance of more than 1,000 luminaries lighting the path through ik'e
wetlands, floating over the lagoon, and spanning across the boardwalk. A beautiful sight of the 161-acre park is surestorbe•a
memory for you and your family. Free to the public. Register at carmelclayparks.com. °
Escape Da Passes are non-refundable.
.1 t.
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.
Frank, Elizabeth Terms
757 Eden Woods Place Date Due
Carmel, IN 46033
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/5/12 966585 Refund $ 25.00
-Total $ 25.00
I 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.
Frank, Elizabeth Allowed 20
757 Eden Woods Place
Carmel, IN 46033
In Sum of$
$ 25.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1096-22 966585 4358400 $ 25.00 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
15-Nov 2012
1P. &
Signature
$ 25.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
i
I