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217270 02/13/2013 CITY OF CARMEL, INDIANA VENDOR: 363407 Page 1 of 1 gf� ONE CIVIC SQUARE SOWMYA NATARAJAN CARMEL, INDIANA 46032 14075 MAGIC STALLION DRIVE CHECK AMOUNT: $150.00 CARMEL IN 46032 CHECK NUMBER: 217270 CHECK DATE: 2/13/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4358400 150 . 00 REFUND p --------------- ------------------------ ACTIVITY REFUND RECEIPT Carmel Clay Receipt# 999996 ���&tecre� eon Payment Date: 01/24/13 �ECF,T' 7 Household#: 29124 Monon Community Center li JAN 2 2013 Carmel IN 46032 S <, owmya Natara'1 an — Hm Ph' _ - -----__ 14075 Magic Station Dr. � (317)564 8111 Carmel IN 46032 Phone: (317)848-7275 sowm a97 ahoo.co Cell Ph: Y @ Fed Tax ID - Y m #35 6000972 Enrollment Details CANCELLATION - Enrollee Name: Refund Of 80.00 Maanav Rajesh Activity Number: 335202-02 Lil' Dragon Taekwond E=L+J@" °U Prey Enrollment Date: 12/03/2012 (Cancelled) 0.00 0.00 ur Pad ° t Due 0.00 0.00 0.00 � Primary Instructor: Indy Taekwondo Academy Class Location: Multi-Purpose Room Monon Community Cntr Class Dates: 01/09/2013 to 02/27/2013 5:15P to 6:OOP Carmel, IN 46032 W (317)848-7275 Scheduled Sessions: 8 Cancel Reason: class cancelled by CCPR CANCELLATION -Refund Of 70.00 Enrollee Name: Maanav Rajesh Activity Number: 335202-05 Lil' Dragon Taekwond S+Tax Enrollment Date: Sc C Paid Amount 0 12/03/2012 (Cancelled) 0.00 0.00 0.00 0.00 o.00 Primary Instructor: Indy Taekwondo Academy Class Location: Multi-Purpose Room Monon Community Cntr Class Dates: 03/06/2013 to 04/24/2013 5:15P to 6:OOP Carmel, IN 46032 W (317)848-7275 Scheduled Sessions: 7 Skip Days 04/03/2013 Cancel Reason: class cancelled by CCPR Processed on 01/24/13 @ 11:18:05 by MJN PREVIOUS NET HOUSEHOLD BALANCE 0.00 FEES CHANGED ON CANCELLED ITEMS(+) 150.00- I NET AMOUNT FROM CANCELLED ITEMS 150.00- 7 5 j �O O TOTAL AMOUNT REFUNDED l 7 150.00 NEW NET HOUSEHOLD BALANCE 0.00 Refund of=_> 150.00 Made B > Y== REFUND FINAN With Reference=_>class cancld by ccpr All refunds are subject to State Board of Accounts procedures and may take 4-6 weeks to process. No cash refunds will be issued, it Page# 1 of 2 ----- ----------------- -------------------------- ------ ---------- ------------------------------------ Carrnei @ Clay ACTIVITY REFUND RECEIPT *Ntv" f< �4 ParksAecreatio n Receipt# 99 Payment 9996 Date: 01/24/2013 013 Household#: II 29124 Authorized Signature —Tate ' te r � Au h ize btignature 12 Y ate Escape Day Passes are non-refundable. Page# 2 of 2 3 Inn,I 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. Natarajan, Sowmya Terms 14075 Magic Stalion Dr Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 1/24/13 999996 Refund $ 150.00 Total $ 150.00 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 - 20_ Clerk-Treasurer Allowed 20 iN 46032 In Sum of$ $ 150.00 ON ACCOUNT OF APPROPRIATION FOR 109 - Monon Center PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1096-32 999996 4358400 $ 150.00 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 7-Feb 2013 signature $ 150.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund