309395 03/24/17 CITY OF CARMEL, INDIANA VENDOR: 120301
ONE CIVIC SQUARE HAMILTON COUNTY TREASURER CHECK AMOUNT: $k k w k 1 1,001.90`
CARMEL, INDIANA 46032 C/O HAMILTON CO AUDITOR CHECK NUMBER: 309395
+M�rtie. 1 HAMILTON COUNTY SQUARE CHECK DATE: 03/24/17
NOBLESVILLEIN 46060
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 11,001.90 OTHER EXPENSES
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PRESCRIBED BY STATE BOARD OF ACCOUNTS CITY AND TOWN FORM 217 CT(1997)
REPORT TO COUNTY AUDITOR OF COURT COSTS
COLLECTED IN CITY/TOWN COURT
To the Auditor of Hamilton County, Indiana
I, Christine Pauley, City Officer of the City of Carmel, Indiana, hereby certify that I have received the
following amounts of the court costs payable to the County:
For the month ending FEBRUARY, 2017.
ITEMIZATION COLLECTIONS PRIOR YEAR TO DATE
THIS PERIOD COLLECTIONS
$10,281.59 $21,283.49
COURT COSTS: $11,001.90
TOTAL AMOUNT COLLECTED $10,281.59 $21,283.49
$11,001.90
Dated , 2017
City Fiscal Officer
NOTE—Mail To:
Hamilton County Auditor
One Hamilton County Square
Noblesville, IN 46060
db`(Make check payable to Hamilton County Treasurer) �`