307609 01/27/17 w��9
�:'' �s CITY OF CARMEL, INDIANA VENDOR: 37145 CHECK AMOUNT: $*`*****`1 1.22`
ONE CIVIC SQUARE ELLEN COLLINS
1 CIVIC SQUARE CHECK NUMBER: 307609
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Q; CARMEL, INDIANA 46032 CARMEL 46032 CHECK DATE: 01/27/17
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DESCRIPTION
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT 22 OTHER FEES & LICENSES
209 4358300 24155270
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Your transaction is complete. Print this receipt for your records. Your receipt identification number
is 24155270. Please reference this number in any correspondence regarding your transaction.
ELLEN COLLINS
Phone
Email
*********** exp. 08/18
E
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.
IN Sec of State 800-236-5446 $11.22
The total amount charged to your credit card is $11.22.
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