246160 06/16/15 CITY OF CARMEL, INDIANA VENDOR: 080501
CHECKAMOUNT: $********11.22*
(9,
ONE CIVIC SQUARE CINDY SHEEKSCARMEL, INDIANA 46032 14382 WHISPER WIND DR CHECK NUMBER: 246160
CARMEL IN 46032 CHECK DATE: 06/16/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 4347500 11.22 NOTARY
Sheeks, Cindy L
From: customerservice@www.IN.gov `
Sent: Monday, June 15, 2015 7:29 PM
To: Sheeks, Cindy L
Subject: SOS Notary and Renewal receipt
Thank you for using the SOS Notary and Renewal online at www.IN.gov. Your transaction is
complete. Your receipt identification number is 16955307. Please reference this number in
any correspondence regarding your transaction.
Payer Information
CYNTHIA SHEEKS
14382 WHISPER WIND DRIVE
CARMEL, IN 46032
Phone : 317 - 714 - 2721
Email : csheeks@carmel.in.gov
Account Information :
5***********4965 exp. 04/16
Transaction Details :
Description Unit Price Quantity Extended Price
Notary Application Fee$10.00 1 $10.00
Instant Access Fee $1.22 1 $1.22
Total :$11.22
The following amounts have been charged to your credit card. Your credit card statement will
show the following merchant name(s) and amount(s) for this transaction.
Merchant Amount
IN Sec of State 800-236-5446 $11.22
The total amount charged to your credit card is $11.22.
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Forth No.201(Rev.1995)
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) bill(s))
OX PJA
Total
I hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF $
$
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
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
- 20
Signatu
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund