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Home My WebLink About233433 06/11/14 CITY OF CARMEL, INDIANA VENDOR: 00351564 ONE CIVIC SQUARE GARY CARTER CHECK AMOUNT: $ .....'15.00' f a° CARMEL, INDIANA 46032 4748 BISHOPSGATE DR CHECK NUMBER: 233433 CARMEL IN 46032 CHECK DATE: 06/11/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4358300 15.00 OTHER FEES & LICENSES State Form 48099(R2/11 10) Approved by State Board of INDIANA CERTIFICATE OF VEHICLE REGISTRATION '\�, % Accounts 2010 CLASS AGE ISSUE DATE PUR DATE COUNTY TP PL YR PLATE PL TP WEIGHT PR YR LS TYPE 06/04/2014 105/21/2014 29-HAMILTON N 2013 MON EXPIRATION DATE PRIOR PLATE VEHICLE YEAR MAKE TYPE MODEL COLOR VEHICLE IDENTIFICATION NUMBER NO EXP 2014 FOR 4W WHI/ 1FM5K8AR4EGC49715 CURRENT EX TAX EX CREDIT DAV CREDIT EX TAX DUE WHEEUSUR STATE REG FEE ADMIN FEE TOTAL DUE YEAR TAX 0.00 10.00 0.00 0.00 0.00 0.00 0.00 0.00 PRIOR EX TAX EX CREDIT DAV CREDIT EX TAX DUE WHEEL/SUR STATE REG FEE ADMIN FEE TOTAL DUE YEAR TAX 0.00 10.00 0.00 0.00 1 0.00 0.00 0.00 0.00 CITY OF CARMEL N 1 CIVIC SQ LB CARMEWN 460322584 IMPORTANT REGISTRATION INFORMATION The registrant acknowledges that the information provided on the front of this form is correct. The registrant understands that proof of financial responsibility(insurance)for this vehicle will be continuously maintained during the registration period. Additional taxes and/or fees may be due if an error or an adjustment to the amount due is made. r'a�C�lr\�S� �t��r�arlQ� Crej. - C--rd) CUSTOMER COPY Bureau of Motor Vehicles Illlllllllllllllllllllllllllllllllllllllllllllllllllllllllallll : . Customer Detailed Transaction Receipt BMV.:`'` State Form 51714 (4-04) Branch: VEHICLE SERVICES- REGISTRATIONS Date: 06/04/2014 Time: 14:05 EDT Visit ID: (193514309 CSR: LB Visit Customer: CITY OF CARMEL Transactions Trans ID Trans Tyne Trans Subtype Amount 235862305 Title-Initial Title Issuance New Title Fee-Vehicle $15.00 Vehicle: 1 FM5K8AR4EGC49715 2014 FOR 4W Lien Holder: None Customer: CITY OF CARMEL Purchase Date: 05/21/2014 $15.00 Charges to your credit card will appear as a line item charge not as a total transaction charge. Page 1 of 1 Bureau of Motor Vehicles . ... Customer Registration Fees Detailed Receipt BMIf: . State Form 51718 (4-04) Branch:(VE�HIICLE SERVICES-REGISTRATIONS Date: 06/04/2014 Time: 12:50 EDT Visit ID: 13514309 Tran ID: 235869617 Visit Customer: CITY OF CARMEL STARS Trans#: 06041480300038 Transaction Type: New Motor Vehicle Registration Registration License Type: MUNICIPAL OWNED Plate\Permit\Registration Number: Vehicle Identification Number: 1 FM5K8AR4EGC49715 Vehicle Year: -- 2014 Vehicle Make: FORD Vehicle Model: EXPLORER POLICE AWD 4 Registration Year Fee Type Subtotal Total 2014 Total for 2014: 2013 NONE (NONE)2013 $0.00 CITY OF CARMEL Total NONE(NONE) 2013: $0.00 Total for 2013: 0.00 Transaction Total: 0.00 Charges to your credit card will appear as a line item charge not as a total transaction charge. Page 1 of 1 APPLICATION FOR CERTIFICATE OF TITLE - STATE OF INDIANA - BUREAU OF MOTOR VEHICLES State Form 205(R7 16-04) Approved by State Board of Account 1997 TO BE COMPLETED BY POLICE OFFICER,BMV OFFICIAL OR BMV CERTIFIED DEALER SIGNEE ONE THE UNDERSIGNED SWEAR OR AFFIRM THAT THE INFORMA- FOR OUT OF STATE TITLES.I HEREBY CER71FY THAT I PERSONALLY EXAMINED THE FOLLOWING TION ENTERED ON THIS FORM IS CORRECT. I/WE UNDERSTAND VEHICLE AND FIND THE IDENTIFICATION NUMBER To BE As Fouows. THAT MAKING A FALSE STATEMENT ON THIS FORM MAY CONSTI- VEHICLE IDENTIFICATION NUMBER TUTE THE CRIME OF PERJURY. FUTHERMORE,VWE AGREE TO INDEMNIFY AND HOLD HARMLESS THE INDIANA BMV FROM ANY R MAKE MODEL TYPE DATE LIABILITY ARISING FROM THIS TRANSACTION. X X INSPECTOR'S PRINTED NAME&TITLE CITY DATE: INSPECTOR'S SIGNATURE The law requires that you apply for Certificate of Title within thirty-one days from the date of purchase of a motor vehicle.There is a delinquent fee of$21.00 for failure to do so.Attach Certificate of Trie assigned by seller.On erf DEALER PLATE NO. dorsed Titles,liens must be released Supporting documents surrendered with this application cannot be returned to the appiF cant.State fee for applying for Title iss18.00.*In accordance with Federal Code 383. TITLE NUMBER BRANCH NO INVOICE NO BMV USE ONLY 1. 06041480300151 803 MV-GOVERNMENT-CERTIFICATE OF ORIGIN *SOC.SEC./FEDERAL I.D.NO APPLICANT'S NAME BMV USE ONLY D 2. CITY OF CARMEL 0 STREET ADDRESS CITY STATE ZIP CODE N 3. ONE CIVIC SQUARE CARMEL IN 46032 0 VEHICLE I.D.NUMBER VEH.YEAR VEH.MAKE VEH.MODEL NO. VEH.TYPE ODOMETER ACTUAL T 4. 1 FM5K8AR4EGC49715 2014 FOR 4W 13 M T FORMER TITLE NUMBER PURCHASE DATE LIEN SPEED PICK UP MAIL DEALER NO. BMV USE ONLY Y P 5. C OF O 05/21/2014 5 No No Yes E FIRST LIEN'S NAME OR SPECIAL MAILING ADDRESS STREET ADDRESS 6. CITY OF CARMEL 1 CIVIC SQ N CITY STATE ZIP CODE BMV USE ONLY CARMEL � IN 46032-2584 T H SECOND LIEN'S NAME STREET ADDRESS 8, S CITY STATE ZIP CODE LICENSE NUMBER LIYEENNSRE FORMS BMV USE ONLY A 9 USED LB R E GROSS RETAIL&USE TAX AFFIDAVIT-IANE HEREBY CERTIFY THAT SALES OR USE TAX ON THIS VEHICLE WAS PAID AS INDICATED BELOW A SELLING PRICE LESS TRADE-IN / DISCOUNT �AMOUNTSUBJECTA DEALER I BRANCH EXEMPT IF EXEMPT 10. $ Q.00 $ O.00 0.00 $ 0.00 $ X PLACE 1 ARA.# *Your Social Security number/Federal I.D.number is being requested by this agency under IC4-1.6-1. Disclosure is mandatory and this document cannot be processed without it APPLICANT RESPONSIBLE FOR ACCURACY OF INFORMATION APPLICATION FOR CERTIFICATE OF TITLE - STATE OF INDIANA - BUREAU OF MOTOR VEHICLES IIVIII VIII III II IIT IIID VIII IIID IIID VIII VIII VIII III 2 0 5 2 3 5 8 6 2 3 0 5 CUSTOMER COPY Prescribed by State Board of Accounts City Form No.201 (Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or 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 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) $15.00 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. ALLOWED 20 Gary Carter IN SUM OF $ $15.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 43-583.00 $15.00 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 AN Am fele 1-- Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund