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245078 5 /13/2015 1°�"'qAM CITY OF CARMEL, INDIANA VENDOR: 00351564 �= °• ONE CIVIC SQUARE GARY CARTER CHECK AMOUNT: $********30.00* +' CARMEL, INDIANA 46032 4748 BISHOPSGATE DR CHECK NUMBER: 245078 9,;•_ CARMEL IN 46032 CHECK DATE: 05/13/15 [TON GO' DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4358300 30.00 OTHER FEES & LICENSES r r• '........... Bureau of Motor Vehicles Customer Transaction Receipt I II I I II I III IIII VIII VIII VIII VIII VIII VIII III yBMU State Form 51717 (4-04) Branch: VEHICLE SERVICES- REGISTRATIONS (803) Date: 4/30/15 Time: 11:37:40 am EDT 100 N SENATE AVE INDIANAPOLIS, IN 46204-2273 Visit ID: 201132962 Visit Customer: CITY OF CARMEL Transactions Trans ID (PIN) Trans Type Trans Subtype Amount 248484776 Title- Initial Title Issuance New $15.00 248485376 Registration - New Motor Vehicle Registration New $0.00 248485825 Title- Initial Title Issuance New $15.00 248486055 Registration - New Motor Vehicle Registration New $0.00 Subtotal: $30.00 Sales/Use Tax: $0.00 Credit Applied: $0.00 Total: $30.00 Payment Method CREDIT Amount -$ 30.00 Merchant ID advc80952we Card Type Authorization Number 02120B Terminal lD 59T18P1 Entry Method K Trans Sequence No 36122856 Batch No 0 Account Number *********'*`X,-- Total Due: $30.00 Amount Paid: $30.00 Change Due: $0.00 Within 10 business days, you will receive your registration or title through the United States mail You will be able to track the progress of your registration or title by using your PIN number listed above when calling the BMV Customer Service Center at 888-myBMV-411 (888-692-6841). If you have questions or comments, please call our Customer Service Center at 888-myBMV-411. Please help us improve our service by completing a one-minute customer satisfaction survey. Your responses are completely confidential. Visit http://www.in.gov/bmvsurvey/start and enter the survey code 201132962 to get started. Thank you. rm . www.Facebook.com/inbmv www.Twitter.com/inbmv ,� www.myBMV.com IIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Customer Copy 5 1 7 1 7 . 2 4 8 4 8 6 0 5 5 Page 1 of 1 State Form 48099(R2/11-10) Approved by State Board of INDIANA CERTIFICATE OF VEHICLE REGISTRATION ccountsCLASS I AGE JISSUE DATE PUR DATE COUNTY TP PL YR PLATE PL TP WEIGHT PR YR LS I TYPE 04/30/2015 04/20/2015,29-HAMILTON N 2014 MO IN EXPIRATION DATE I PRIOR PLATE I VEHICLE YEAR I MAKE TYPE MODEL COLOR VEHICLE IDENTIFICATION NUMBER NO EXP 2015 FOR 4W WHI/ 1 FM5K8ARXFGC41183 CURRENT EX TAX EX CREDIT DAV CREDIT EX TAX DUE WHEEUSUR STATE REG FEE ADMIN FEE TOTAL DUE YEAR TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 PRIOR EX TAX EX CREDIT DAV CREDIT EX TAX DU WHEEUSUR STATE REG FEE ADMIN FEE TOTAL DUE YEAR TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 CITY OF CARMEL N 1 CIVIC SQ LB CARMEL,IN 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. CUSTOMER COPY State Form 48099(R2/11-10) Approved by State Board of INDIANA CERTIFICATE OF VEHICLE REGISTRATION A CLASS AGE I ISSUE DATE I PUR DATECOUNTY TP PL YR PLATE PL TP WEIGHT PR YR ILS TYPE 04/30/2015 04/20/2015 29-HAMILTON N 2014 MO N EXPIRATION DATE I PRIOR PLATE VEHICLE YEAR I MAKE TYPE MODEL COLOR VEHICLE IDENTIFICATION NUMBER NO EXP 1 2015 FOR 4W WHI/ 1 FM5K8AR1 FGC41184 CURRENT EX TAX EX CREDIT DAV CREDIT EX TAX DUE WHEEUSUR STATE REG FEE ADMIN FEE TOTAL DUE YEAR TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 PRIOR EX TAX EX CREDIT DAV CREDIT EX TAX Duq 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 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. CUSTOMER COPY VOUCHER NO. WARRANT NO. ALLOWED 20 Gary Carter IN SUM OF$ $30.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#IrITLE AMOUNT Board Members 1120 43-583.00 $30.00 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 MAY 1 1 2015 Fire Chief _ l Title Cost distribution ledger classification if claim paid motor vehicle highway fund 1 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)) $30.00 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