243980 04/08/15 V 362629
CITY OF CARMEL, INDIANA VENDOR:
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...«...«•�• N DIVISION IAI CHECK AMOUNT: $ 20.00
ONE CIVIC SQUARE INDIANA V I I
°. CARMEL, INDIANA 46032 SEAN MATUSKO,SECRETARY CHECK NUMBER: 243980
y�roN 550 W 16TH ST,SUITE C CHECK DATE: 04/08/15
INDIANAPOLIS IN 46202
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4355300 20.00 ORGANIZATION & MEMBER
`aVONAI.SV'S�0
zP�� 9 INDIANA DIVISION OF
o THE INTERNATIONAL ASSOCIATION FOR
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IDENTIFICATION
MEMBERSHIP RENEWAL FORM
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Please complete this form to renew your Indiana IAI Membership for the coming year. Return the signed
form with a check or money order for$20.00 payable to "Indiana Division IAI" to the Secretary/Treasurer
at the address below, OR you may scan the signed form and email it to the Secretary/Treasurer at the
email address below and pay through PayPal on our website at www.iniai.org/Membership.
The information on this form will be used to prepare the Member Directory, so please check addresses,
telephone numbers, and email addresses for accuracy. Your membership letter will be sent upon receipt
of your renewal form and payment. Members must pay annual dues on or before April 1St each year to
remain in good standing.
Sean Matusko, Secretary/Treasurer
550 West 16th Street; Suite C
Indianapolis, IN 46202
sdmatuskoO-comcast.net
Federal Employer Identification Number: 35-1934954
Indiana IAI Member Number: IN006 Membership Level: ® Active ❑Associate
Name: John R Elliott
Are you a Member of the IAI Parent Body? ® Yes: Member Number: 12344 ❑ No
Employer(Agency or Company): Carmel Police Department
Title or Position: Inspector
Office Address: 3 Civic Square
City: Carmel State: Indiana Zip Code: 46032
Office Telephone Number: (317)571-2515 Fax Number: (317)571-2508
Office Email Address: jelliott@carmel.in.gov
Changes from Prior Year: no
I wish to renew my membership in the Indiana Division of the International Association for Identification. I
continue to meet all the require a as stated in the Constitution and Bylaws.
Member's Signature: Date:3—� ��
IAI Office Use Only
Received: Form of Payment:
Receipt Number: Record Updated: Member Notified:
VOUCHER NO. WARRANT NO.
Indiana Division IAI
f ALLOWED 20
Secretary-Treasurer I IN SUM OF$
550 W 16th St, Suite C
Indianapolis, IN 46202
$20.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#I Dept. INVOICE NO. ACCT#1TITLE AMOUNT Board Members
1110 43-553.00 $20.00 I 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
Thurs y, March 26, 2015
�Z i
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
I
I
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))
03/26/15 Membership Dues-John Elliott $20.00
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