315241 08/29/17 w G�q
''*. CITY OF CARMEL, INDIANA VENDOR: 358941
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D ONE CIVIC SQUARE PETTY CASH - BROOKSHIRE GOLF COUQdjCK AMOUNT: $......**49.47*
s rQ: CARMEL, INDIANA 46032 C/O PAM LISTER CHECK NUMBER: 315241
'''roe CHECK DATE: 08/29/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1207 4355300 SUMTER 49.47 ORGANIZATION & MEMBER
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Welcome to Indiana Licensing Page 1 of 1
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Payment Receipt
This page serves as your receipt for this transaction. Your payment will appear on your credit
card statement as "STATE OF IN WWW INGOV 800-236-5446 IN".
New Application
• Completion of Server Training is required within 120 days of issuance of this permit. Click
here to complete Server Training online
• A BMV Operating While Intoxicated (OWI) Check is preformed on every application prior to
issuing a permit. Please allow 24 - 48 hours to complete the check before your permit will be
issued.
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in the mail.
• This receipt must be printed now. You will not be albe to reproduce it at a later time.
• All permit application and renewal fees are now non-refundable.
Payment received - thank you.
Licensee: Sumter McClure DaVega
License Number: Pending
Authorization Code: 240048
Received Date: 8/22/2017 10:22:39 AM
Transaction ID: 78179450
Credit Card Number: XXXX XXXX XXXX 6072
Fee Amount: $45.00
Enhanced Fee: $2.50
Instant Fee: $1.97
Total Payment: $49.47
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