223284 08/13/2013 CITY OF CARMEL, INDIANA VENDOR: 367442 Page 1 of 1
s ONE CIVIC SQUARE BRYAN WHITEMAN CHECK AMOUNT: $52.00
CARMEL, INDIANA 46032 911 CHERRY DR
JEFFERSONVILLE IN 47130 CHECK NUMBER: 223284
CHECK DATE: 8/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 52 . 00 PARKS DEPARTMENT REFU
ACTIVITY REFUND RECEIPT
Receipt# 1119016
Carmel e Clay Payment Date: 07/30/13
Parks&Recreation Household #: 54948
Monon Community Center Bryan Whiteman Hm Ph: (502)939-3866
Carmel IN 46032 911 Cherry Dr.
Jeffersonville IN 47130 Cell Ph:
whitemania @gmail.com
Phone: (317)848-7275
Fed Tax ID #35-6000972
Enrollment Details
CANCELLATION - Refund Of 52.00
Enrollee Name: Bryan Whiteman Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 137006-01 MCC Summer Open 2013 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 07/24/2013 (Cancelled)
Class Location: Gymnasium A Class Dates: 08/03/2013 to 08/03/2013
Monon Community Cntr 8:OOA to 8:OOP JUL 3 12013
Sa
Carmel, IN 46032 Scheduled Sessions: 1 �
(317)848-7275
Cancel Reason: low enrollment
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 07/30/13 @ 14:13:13 by MML FEES CHANGED ON CANCELLED ITEMS(+) 52.00-
NET AMOUNT FROM CANCELLED ITEMS 52.00
TOTAL AMOUNT REFUNDED 52.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 52.00 Made By=_>REFUND FINAN With Reference=_>low enrollment
All refunds are subject to State Board of Accounts procedures and may take 4-6 wee o process. No cash refunds will be
issued.
ae� c 3
AUtKorized Signa ure Dat / ZAuthoriz' iP4e Da
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.
Whiteman, Bryan Terms
911 Cherry Dr. Date Due
Jeffersonville, IN 47130
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/30/13 1119016 Refund 52.00
Total $ 52.00
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
20_
Clerk-Treasurer
Voucher No. Warrant No.
Whiteman, Bryan Allowed 20
911 Cherry Dr.
Jeffersonville, IN 47130
In Sum of$
$ 52.00
ON ACCOUNT OF APPROPRIATION FOR
109 - MCC
PO#or Board Members
INVOICE NO. ACCT#/TITLE AMOUNT
Dept#
1096-50 1119016 4358400 $ 52.00 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
8-Aug 2013
Signature
$ 52.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund