The URL can be used to link to this page

Home My WebLink About312175 06/09/17 9�>; ,�� CITY OF CARMEL, INDIANA VENDOR: 00351564 ONE CIVIC SQUARE GARY CARTER CHECK AMOUNT: $R R R R R R R 845.00" +3�+` CARMEL, INDIANA 46032 4748 BISHOPSGATE DR CHECK NUMBER: 312175 o CARMEL IN 46032 CHECK DATE: 06/09/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4358300 45.00 OTHER FEES & LICENSES k > / / O § � 2 2 2 03f o / ? > m \_ z q � k k k ƒ CYI O f o / a _ U k # D % q 0 -u E Al -n > q k / / G k � _ m 30 7 & ® � / > � O CDr. Z | 7 o a & \ 0 / \ CD k k g i F / 7 $ � m , , m H j e f a _ O C § 4 » 3 \ f CD k i • \ / CL C— m § CD % \ § \ % 2 S 0 _k ( % % NCD ` _ o \ i E 5 ; w a) ; w \ E E f §CLN CD 3 | � / k� $ qQ { 7 > C < _( CL$ C) \ j m cL\ ocr /� D � $ 0 m nk � 0 \ [ _ o - /} § k ƒ \= C a ) /� k � \ 0 Z ( \ \ c-5, / 0 0 > f }ƒ 0 $ 0 -n � $oKg a E 7 % q / r CD m CL 2 0 \ ® ' A $ G / \ § 7 \ § i O 3 = ] C:% CD $ E m \ K o CDCL2 \ M } k Q CD / £ } CD K � \ \ \ E_ 402 � o % k } Bureau of Motor Vehicles IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII) `D Customer Detailed Transaction Receipt State Form 51714 (4-04) Branch: VEHICLE SERVICES - REGISTRATIONS Date: 05/22/2017 Time: 9:24 EDT Visit ID: (21998407 CSR: SL Visit Customer: CITY OF CARMEL Transactions Trans ID Trans Type Trans Subtvne Amount 278641830 Title- Initial Title Issuance New Title-Vehicle $15.00 Vehicle: 1 FM5K8D82HGC78492 2017 FOR EXP UT Lien Holder: None Customer: CITY OF CARMEL Purchase Date: 04/24/2017 278641935 Title- Initial Title Issuance New Title-Vehicle $15.00 Vehicle: 1 FM5K8D80HGC78491 2017 FOR EXP UT Lien Holder: None Customer: CITY OF CARMEL Purchase Date: 04/24/2017 278642571 Title- Initial Title Issuance New Title-Vehicle $15.00 Vehicle: 1 FM5K8D89HGC78490 2017 FOR EXP UT Lien Holder: None Customer: CITY OF CARMEL Purchase Date: 04/25/2017 $45.00 Bureau of Motor Vehicles •'*�_�*�• Customer Transaction Receipt I IIIIIIII III VIII IIID IIID VIII VIII VIII VIII IIII •BMV• State Form 51717 (R 14-16) Branch: VEHICLE SERVICES - REGISTRATIONS(803) Date: 5/22/17 Time: 9:24:58 am EDT 100 N SENATE AVE INDIANAPOLIS, IN 46204-2273 Visit ID: 219598407 Visit Customer: CITY OF CARMEL Transactions Trans ID (PIN) Trans Type Trans Subtype Amount 278641830 Title- Initial Title Issuance New $15.00 278641870 Registration - New Motor Vehicle Registration New $0.00 278641935 Title- Initial Title Issuance New $15.00 278641992 Registration - New Motor Vehicle Registration New $0.00 278642571 Title- Initial Title Issuance New $15.00 278642613 Registration - New Motor Vehicle Registration New $0.00 Subtotal: $45.00 Sales/Use Tax: $0.00 Credit Applied: $0.00 Total: $45.00 Payment Method CREDIT Amount $ 45.00 Merchant ID 803BMV Card Type MASTERCARD Authorization Number 03557B Terminal ID 2UA52319F5 Entry Method K Trans Sequence No 74793408 Batch No 0 Account Number ************7551 Total Due: $45.00 Amount Paid: $45.00 Change Due: $0.00 ***IMPORTANT NOTICE*** If you do not receive your credential, registration or title within 14 days or you have questions regarding the print/mailing status of your credential, registration or title, please visit www.myBMV.com and create or log into your account or call the BMV Contact Center at 888-692-6841. You will be able to track the progress of your registration or title by using your Transaction ID PIN number listed above and calling 888-692-6841. Please allow 30 days to receive an approved Personalized License Plate. You may renew your motorcycle learner's permit only one time for one year. If you do not obtain a motorcycle endorsement before the expiration of the renewed motorcycle learner's permit, you must wait one year to apply for a new permit(IC 9-24-8-3). www.Facebook.com/inbmv www.Twitter.com/inbmv Wo www.myBMV.com 111 I11I 11IIIIIIIIIIIIIIIIIIIIIIIIIITIIIII11Customer Copy IIIIIIII 5 1 7 1 7 2 7 8 6 4 2 6 1 3 I- Bureau of Motor Vehicles '=��j*, Customer Transaction Receipt IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIII BMV� 0 State Form 51717 (R /4-16) Branch: VEHICLE SERVICES- REGISTRATIONS(803) Date: 5/22/17 Time: 9:24:58 am EDT 100 N SENATE AVE INDIANAPOLIS, IN 46204-2273 Visit ID: 219598407 Visit Customer: CITY OF CARMEL 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 219598407 to get started. Thank you. 91 www.Facebook.com/inbmv www.Twitter.com/inbmv www.myBMV.com IIIIIIf�IIIIIIIIIIIIIIII 11 I1111111IIIIIIIIIIIIIIIIIIIIIIIIII 11I Customer Copy 5 1 7 1 7 2 7 6 6 4 2 6 1 3 ____ „ _ - Approved e vedbyStaState Form 48099 (Boardof INDIANA CERTIFICATE OF VEHICLE REGISTRATION _, Accounts 2016 CLASS I AGE I ISSUE DATE I PUR DATE COUNTY TP PL YR PLATE PL I L TPWEIGHT PR YR LS TYPE PRIOR YR PL 05/22/2017 04/25/2017 29-HAMILTON N 16 MO N EXPIRATION DATE MUNICIPALITY VEHICLE YEAR MAKE I MODEL I VEHICLE IDENTIFICATION NUMBER I TYPE I COLOR NO EXP 2017 FOR EXP 1 FM5K8D89HGC78490 4W WHI/ CURRENT EX TAX EX CREDIT DAV CREDIT NET EX TAX CO.WHEEUSUR MUN.WHEEUSUR STATE REG FEE ADMIN FEE TOTAL YEAR TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 PRIOR EX TAX EX CREDIT DAV CREDIT NET EX TAX CO.WHEEUSUR MUN.WHEEUSUR STATE REG FEE ADMIN FEE TOTAL YEAR TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 REGISTRATION LICENSE TYPE MUNICIPAL OWNED CITY OF CARMEL N 2 CIVIC SQ SL CARMEL, IN 46032-2584 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 °4, APPLICATION FOR CERTIFICATE OF TITLE FOR A VEHICLE State Form 205(R9/7-16) Approved by State Board of Accounts,2016 �' INDIANA BUREAU OF MOTOR VEHICLES r_�e `This agency is requesting disclosure of your Social Security Number/Federal Identification Number in accordance with IC 4-1-8-1;disclosure is mandatory,and this record cannot be processed without it To be completed by a police officer, BMV official,or BMV certified I swear and affirm that I am authorized to perform this transaction,and dealer signee for out-of-state titles. I hereby certify that I personally I agree to indemnify and hold harmless the Indiana BMV from any and examined the following vehicle and find the identification number to all liability arising from this transaction. be as follows. 1 swear and affirm that the information that I have entered on this form Vehicle Identification Number is correct.I understand that making a false statement on this form may constitute the crime of perjury. Applicant Signature: Year Make Model Type Date(mm/dd/yyyy) Printed Name: Inspector's Printed Name and Title City Applicant Signature: Printed Name: Inspector's Signature Badge,Branch,or Dealer Plate Number Date(mm/dd/yyyy): Transaction Number Branch Number Invoice Number BMV Use Only 05221780300050 803 MV-GOVERNMENT-CERTIFICATE OF ORIGIN Social Security Number/Federal Identification Number` Name of Applicant BMV Use Only CITY OF CARMEL Residence Address(number and street) City State ZIP Code 1 CIVIC SQUARE CARMEL IN 46032 Vehicle Identification Number Vehicle Year Vehicle Make Vehicle Model Vehicle Type Odometer ACTUAL 1 FM5K8D89HGC78490 2017 FOR EXP 4W 12 M Former Title Number Purchase Date(mm/dd/yyyy) Lien(Y/N) Speed(YIN) Dealer Number BMV Use Only C OF 0 04/25/2017 5 No Holder of First Lien,Mortgage,or Other Encumbrance/Special Mailing Address Mailing Address(number and street) CITY OF CARMEL 1 CIVIC SQ City State ZIP Code BMV Use Only CARMEL IN 46032-2584 Holder of Second Lien,Mortgage,or Other Encumbrance Mailing Address(number and street) city State ZIP Code License Number License Year Forms Use BMV Use Only SL Gross Retail and Use Tax Affidavit-I/We hereby certify that sales or use tax on this vehicle was paid as indicated below. Selling Price Less Trade-In/Discount Amount Subject to Tax Amount of Tax Dealer Branch Exempt Exemption Code $ 0.00 $ 0.00 0.00 $ 0.00 $ X 1 II VIII VIII III II(IIII IIID VIII III I VIII VIII VIII(IIII III 2 0 5 2 7 8 6 4 2 5 7 1 CUSTOMER COPY 0State Form 48099(R4/1-17) Approved by State Board of INDIANA CERTIFICATE OF VEHICLE REGISTRATION Accounts 2016 CLASS I AGE I ISSUE DATE I PUR DATE COUNTY TP PL YR PLATE PL TP WEIGHT PR YR LS TYPE PRIOR YR PL 05/22/2017 04/24/2017 29-HAMILTON N 16 MO N EXPIRATION DATE MUNICIPALITY VEHICLE YEAR MAKE MODEL VEHICLE IDENTIFICATION NUMBER TYPE COLOR NO EXP 2017 FOR EXP 1 FM5K8D80HGC78491 4W WHI/ CURRENT EX TAX EX CREDIT DAV CREDIT NET EX TAX CO.WHEEUSUR MUN.WHEEUSUR STATE REG FEE ADMIN FEE TOTAL YEAR TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 PRIOR EX TAX EX CREDIT DAV CREDIT NET EX TAX CO.WHEEUSUR MUN.WHEEUSUR STATE REG FEE ADMIN FEE TOTAL YEAR TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 REGISTRATION LICENSE TYPE MUNICIPAL OWNED CITY OF CARMEL N 2 CIVIC SQ SL CARMEL, IN 46032-2584 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 APPLICATION FOR CERTIFICATE OF TITLE FOR A VEHICLE State Form 205(R9/7-16) ' Approved by State Board of Accounts,2016 INDIANA BUREAU OF MOTOR VEHICLES *This agency is requesting disclosure of your Social Security Number/Federal Identification Number in accordance with IC4-1-8-1;disclosure is mandatory,and this record cannot be processed without it To be completed by a police officer, BMV official,or BMV certified I swear and affirm that I am authorized to perform this transaction,and dealer signee for out-of-state titles. I hereby certify that I personally I agree to indemnify and hold harmless the Indiana BMV from any and examined the following vehicle and find the identification number to all liability arising from this transaction. be as follows. I swear and affirm that the information that I have entered on this form Vehicle Identification Number is correct. I understand that making a false statement on this form may constitute the crime of perjury. Applicant Signature: Year Make Model Type Date(mm/dd/yyyy) Printed Name: Inspector's Printed Name and Title City Applicant Signature: Printed Name: Inspector's Signature Badge,Branch,or Dealer Plate Number Date(mm/dd/yyyy): Transaction Number Branch Number Invoice NumberBMV Use Only 05221780300040 803 MV-GOVERNMENT-CERTIFICATE OF ORIGIN Social Security Number/Federal Identification Number* Name of Applicant BMV Use Only CITY OF CARMEL Residence Address(number and street) City State ZIP Code 1 CIVIC SQUARE CARMEL IN 46032 Vehicle Identification Number Vehicle Year Vehicle Make Vehicle Model Vehicle Type Odometer ACTUAL 1 FM5K8D80HGC78491 2017 FOR EXP 4W 12 M Former Title Number Purchase Date(mm/dd/yyyy) Lien(YIN) Speed(YM) Dealer Number BMV Use Only C OF 0 04/24/2017 5 No Holder of First Lien,Mortgage,or Other Encumbrance/Special Mailing Address Mailing Address(number and street) CITY OF CARMEL 1 CIVIC SQ City State ZIP Code BMV Use Only CARMEL IN 46032-2584 Holder of Second Lien,Mortgage,or Other Encumbrance Mailing Address(number and street) City State ZIP Code License Number License Year Forms Use BMV Use Only SL Gross Retail and Use Tax Affidavit-I/We hereby certify that sales or use tax on this vehicle was paid as indicated below. Selling Price Less Trade-in/Discount Amount Subject to Tax Amount of Tax Dealer Branch Exempt Exemption Code $ 0.00 $ 0.00 0.00 $ 0.00 $ X 1 IIIIIIIIIIIIIII II VIII VIII VIII VIII VIII VIIIIIIIIIIIIIII 2 0 5 2 7 8 6 4 1 9 3 5 CUSTOMER COPY Sta e Form 48099 134/1-17) Approved tbyStaelBoardof INDIANA CERTIFICATE OF VEHICLE REGISTRATION Accounts 2016 CLASS I AGE I ISSUE DATE I PUR DATE COUNTY TP PL YR PLATE PL TP I WEIGHT I PR YR I LS I TYPE I PRIOR YR PL 05/22/2017 04/24/2017 29-HAMILTON N 1 16 MO N EXPIRATION DATE MUNICIPALITY VEHICLE YEAR MAKE I MODEL I VEHICLE IDENTIFICATION NUMBER TYPE I COLOR NO EXP 2017 FOR EXP 1 FM5K8D82HGC78492 4W RED/ CURRENT EX TAX EX CREDIT DAV CREDIT NET EX TAX CO.WHEEUSUR MUN.WHEEUSUR STATE REG FEE ADMIN FEE TOTAL YEAR TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 PRIOR EX TAX EX CREDIT DAV CREDIT NET EX TAX CO.WHEEUSUR MUN.WHEEUSUR STATE REG FEE ADMIN FEE TOTAL YEAR TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 REGISTRATION LICENSE TYPE MUNICIPAL OWNED CITY OF CARMEL N 2 CIVIC SQ SL CARMEL, IN 46032-2584 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 APPLICATION FOR CERTIFICATE OF TITLE FOR A VEHICLE t State Form 205(R9/7-16) Approved by State Board of Accounts,2016 INDIANA BUREAU OF MOTOR VEHICLES 'This agency is requesting disclosure of your Social Security Number/Federal Identification Number in accordance with IC 4-1-8-1;disclosure is mandatory,and this record cannot be processed without it To be completed by a police officer, BMV official,or BMV certified I swear and affirm that I am authorized to perform this transaction,and dealer signee for out-of-state titles. I hereby certify that I personally I agree to indemnify and hold harmless the Indiana BMV from any and examined the following vehicle and find the identification number to all liability arising from this transaction. be as follows. I swear and affirm that the information that I have entered on this form Vehicle Identification Number is correct.I understand that making a false statement on this form may constitute the crime of perjury. Applicant Signature: Year Make Model Type Date(mm/dd/yyyy) Printed Name: Inspector's Printed Name and Title city Applicant Signature: Printed Name: Inspector's Signature Badge,Branch,or Dealer Plate Number Date(mm/dd/yyyy): Transaction Number Branch Number Invoice Number Bryce Use Only 05221780300039 803 MV-GOVERNMENT-CERTIFICATE OF ORIGIN Social Security Number/Federal Identification Number' Name of Applicant BMV Use Only CITY OF CARMEL Residence Address(number and street) City State ZIP Code 1 CIVIC SQUARE CARMEL IN 46032 Vehicle Identification Number Vehicle Year Vehicle Make Vehicle Model Vehicle Type Odometer ACTUAL 1 FM5K8D82HGC78492 2017 FOR EXP 4W 12 M Former Title Number Purchase Date(mm/dd/y)yy) Lien(Y/N) Speed(YIN)I Dealer Number BMV Use Only C OF O 04/24/2017 5 No Holder of First Lien,Mortgage,or Other Encumbrance/Special Mailing Address Mailing Address(number and street) CITY OF CARMEL 1 CIVIC SQ City State ZIP Code BMV Use Only CARMEL IN 46032-2584 Holder of Second Lien,Mortgage,or Other Encumbrance Mailing Address(number and street) City State ZIP Code License Number License Year Forms Use BMV Use Only SL Gross Retail and Use Tax Affidavit-UWe hereby certify that sales or use tax on this vehicle was paid as indicated below. Selling Price Less Trade-In/Discount Amount Subject to Tax Amount of Tax Dealer Branch Exempt Exemption Code $ 0.00 $ 0.00 0.00 $ 0.00 $ X 1 II IIID VIII III II III I VIII(IIII III I(IIII VIII VIII VIII III 2 0 5 2 7 8 6 4 1 8 3 0 CUSTOMER COPY