220835 06/04/2013 CITY OF CARMEL, INDIANA VENDOR: 367194 Page 1 of 1
° ONE CIVIC SQUARE MATT WIGGINS
CARMEL, INDIANA 46032 6134 TERRA LANE CHECK AMOUNT: $18.00
•, _o���� MCCORDSVILLE IN 46055 CHECK NUMBER: 220835
CHECK DATE: 6/4/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 1056122 18 . 00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
Receipt# 1056122
Carmel @ Clay Payment Date: 05/30/13
larks&Recreation Household #: 35465
ID
Monon Community Center s JUN 0 3 2013 Matt Wiggins Hm Ph: (317)716-7915
Carmel IN 46032 I 6134 Terra Ln
Phone: (317)848-7275
McCordsville IN 46055 Cell Ph:(317)335-3861
'' - --
`-"- -- �"----—�—
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION - Refund Of 18.00
Enrollee Name: Sally Wiggins Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 137031-01 Introduction to Self 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 04/04/2013 (Cancelled)
Primary Instructor: Dog Ear Publishing
Class Location: Meeting Room Class Dates: 06/04/2013 to 06/25/2013
Monon Community Cntr 7:30P to 8:15P
Tu
Carmel, IN 46032 Scheduled Sessions: 4
(317)848-7275
cancel Reason: low enrollment
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 05/30/13 @ 16:15:30 by MML FEES CHANGED ON CANCELLED ITEMS(+) 18.00-
NET AMOUNT FROM CANCELLED ITEMS 18.00-
TOTAL AMOUNT REFUNDED 18.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 18.00 Made By==>REFUND FINAN With Reference==>low enrollment
All refunds are subject to State Board of Accounts procedures and may take 4-6 eeks to process. No cash refunds will be
issued.
Authorized Signature Date Z Vth/zedp6ature D afe
(01X0.59, q 351?�O'_1)
Escape 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.
Wiggins, Matt Terms
6134 Terra Ln Date Due
McCordsville, IN 46055
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/30/13 1056122 Refund $ 18.00
Total $ 18.00
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
Voucher No. Warrant No.
Wiggins, Matt Allowed 20
6134 Terra Ln
McCordsville, IN 46055
In Sum of$
$ 18.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or Board Members
Dept#
INVOICE NO. ACCT#/TITLE AMOUNT
1096-50 1056122 4358400 $ 18.00 1 hereby certify that the attached invoice(s), or
bil(s) is (are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
3-Jun 2013
gnature
$ 18.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund