252154 1 2/02/1 5 �,qyf CITY OF CARMEL, INDIANA VENDOR: 370093
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® ONE CIVIC SQUARE TYLER CALLAHAN CHECK AMOUNT: $**.....136.00*
,. r° CARMEL, INDIANA 46032 17350 SUNSET MAPLE LANE#717 CHECK NUMBER: 252154
+M,roN,Eo�• WESTFIELDIN 46074 CHECK DATE: 12/02/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 REIMB 136.00 OTHER EXPENSES
x * , Bureau of Motor Vehicles IIIIIIIIIIIIIIIIII IIII
Customer Transaction Receipt
•
BMV* State Form 51717 (4-04)
1 .
Branch: CARMEL STARS(527) Date: 11/20/15 Time: 1:30:16 pm EDT
12955 OLD MERIDIAN ST STE 107
CARMEL, IN 46032-7106
Visit ID: 206296319
Visit Customer: TYLER WAYNE CALLAHAN
Transactions
Trans ID (PIN) Trans Type Trans Subtype Amount
256710573 Driver- Renew License Renew $36.00
256710705 Customer-Amend Customer Amend $0.00
256710958 Customer-Voter Registration New $0.00
Subtotal: $36.00
Sales/Use Tax: $0.00
Credit Applied: $0.00
Totat $36.00
Payment Method CREDIT Amount $ 36.00
Merchant ID 527BMV Card Type MASTERCARD Authorization Number 133058
Terminal ID 2UA5311CTW Entry Method S Trans Sequence No 51585138
Batch No 0 Account Number ************0900
Total Due: $36.00
Amount Paid: $36.00
Change Due: $0.00
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IIIIII III I II IIIIVIIIIIIIIIII I IIIIIIIIIIII Customer Copy
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Page 1 of 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
T0669
CALLAHAN, TYLER Purchase Order No.
wastewater plant Terms
Due Date 11/24/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/24/201! CALLAHAN $100.00
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
Date Officer
VOUCHER # 156742 WARRANT # ALLOWED
T0669 IN SUM OF $
CALLAHAN, TYLER
wastewater plant
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
CALLAHAN 01-7040-01 $100.00
cullcl`�nl,�
0I -7040.01 36.00,
1�3 b.oa
Voucher Total
Cost distribution ledger classification if
claim paid under vehicle highway fund,