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Home My WebLink About333375 12/14/18 %� "• CITY OF CARMEL, INDIANA VENDOR: 00351564 j ONE CIVIC SQUARE GARY CARTER CHECK AMOUNT: $********15.00* s. i' CARMEL, INDIANA 46032 4748 BISHOPSGATE DR CHECK NUMBER: 333375 M�rowgo� CARMEL IN 46032 CHECK DATE: 12/14/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4358300 15.00 OTHER FEES & LICENSES VOUCHER NO. W_ARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) vendor# 00351564 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER GARY CARTER IN SUM OF$ CITY OF CARMEL _ 4748 BISHOPSGATE DR An invoice or bill to be properly itemized must show:kind of service,where performed,dates service rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. CARMEL, IN 46032 Payee $15.00 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 0 43-583.00 $15.00 1 hereby certify that the attached invoice(s),or 12/11/18 0 Title Fee-Moriarty Vehicle $15.00 1120 101 1120 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Tuesday, December 11,2018 David Haboush Fire Chief 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 5-11-10-1.6 120- Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer i Bureau of Motor Vehicles *7-A�'. Customer Transaction Receipt IIIIIIII III(IIII IIIII IIIII IIIII IIIII(IIII IIIII IIII BMV. State Form 51717 (R/ 4-16) Branch: VEHICLE SERVICES - REGISTRATIONS(803) Date: 12/6/18 Time: 1:44:49 pm EDT 100 N SENATE AVE INDIANAPOLIS, IN 46204-2273 Visit ID: 234668455 Visit Customer: CITY OF CARMEL Transactions Trans ID (PING Trans Type Trans Subtype Amount 302594722 Registration - New Motor Vehicle Registration New $0.00 302594609 Title- Initial Title Issuance New $15.00 Subtotal: $15.00 Sales/Use Tax: $0.00 Credit Applied: $0.00 Transaction Fee: $0.00 Total: $15.00 Payment Method CREDIT Amount $ 15.00 Merchant ID 803BMV Card Type MASTERCARD Authorization Number 03413Z Terminal ID 2UA52319GZ Entry Method K Trans Sequence No 96238188 Batch No 0 Account Number ************4742 Total Due: $15.00 Amount Paid: $15.00 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.mVBMV.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 www.myBMV.com II IIII II IIII I I II IIIIIIIIIIIIIIIIIIIIIIIIIiIIIIIIIIIIIIIIII . Customer Copy 5 1 7 1 7 3 0 2 5 9 4 6 0 9 Page 1 of 2 Bureau of Motor Vehicles IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Customer Detailed Transaction Receipt BMV x State Form 51714 (4-04) 1 Branch: VEHICLE SERVICES-REGISTRATIONS Date: 12/06/2018 Time: 13:44 EDT Visit ID: TM68455 CSR: LA Visit Customer: CITY OF CARMEL Transactions Trans ID Trans Type Trans Subtype Amount 302594609 Title-Initial Title Issuance New Title-Vehicle $15.00 Vehicle: 1 FM5K8D89JGC83176 2018 FOR EXP UT Lien Holder: None Customer: CITY OF CARMEL Purchase Date: 10/31/2018 $15.00 Charges to your credit card will appear as a line item charge not as a total transaction charge. Page 1 of 1 = ASSETS SCREEN Asset Number. F009033 Location Code, Car 413 ( Last Inventory/Update Date: 10/31/2018 1 .' } Asset Code VEHICLE } Follow-Up Date: --" Manufacturer: FORD Asset Description:- 2018 White SUV ,Model: Explorer Serial Numbe 11783 M5K8D89JGC176 Status. 1 ACTIVE Acquired From: Tom Wood Ford Warranty Expires,, Invce Number: PO Number: ._ : } oi Asset Cost Asset'Value.' $29,566.59 _ — -- Custodian: _ Departmhas ent:, �, Purce Date: 10/31/2018` Fund: I Estimated Lif Disposal'Date: � Asset Type: }} Dollar Amount: j Add Delete J S�ave I• Print Find Bureau of Motor Vehicles Customer Registration Fees Detailed Receipt VIII IIIIIIIIIIIIIII IIIIIII IIIIIIIIIII I)IIIIIIIIIIIIIII IIIIII * MV• State Form 51718(4-04) Branch:VEHICLE SERVICES-REGISTRATIONS(803) Date: 12/06/2018 Time: 13:42 EDT Visit ID: 234668455 Tran ID: 302594722 Visit Customer: CITY OF CARMEL STARS Trans# 12061880300021 -_ Transaction Type New Motor Vehicle Registration .,=.Registration License Type: MUNICIPAL OWNED PlatelPermitlRegistration Number: Vehicle Identification Number: 1 FM5K8D89JGC83176 Vehicle Year: 2018 Vehicle Make: FORD Vehicle Model:. EXPLORER XLT Registration Year Fee Type Subtotal Total 2018 Total for 2018: 2017 NONE 2017 $0.00 CITY OF CARMEL Total NONE 2017: $0.00 - Total for 2017: 0.00 Transaction Total: 0.00 �IIII!IIII I��I III�II�I 5 1 7 1 8 Charges to your credit card will appear as a line item charge not as a total transaction charge. Page 1 of 1 ST4Tp" APPLICATION FOR CERTIFICATE OF TITLE FOR A VEHICLE a ; •. ?' 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(mmlddlyyyy) —= - _ Printed Name: Inspector's Printed Name and Title City Applicant Signature: - Printed Name: Inspector's Signature Badge,Branch,or Dealer Plate Number, =— Date(mmlddlyyyy): Transaction Number Branch Number Invoice Number BMV Use Only 12061880300107 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 2 CIVIC SQ CARMEL IN 46032-7543 Vehicle Identification Number Vehicle Year Vehicle Make Vehicle Model Vehicle Type Odometer ACTUAL 1 FM5K8D89JGC83176 2018 FOR EXP I TK 146 M Former Title Number Purchase Date(mmlddlyyyy) Lien(Y/N) Speed(YIN)I Dealer Number BMV Use Only C OF O \ 10/31/2018 5 No Holder of First Lien,Mortgage,or Other Encumbrance/Special Mailing Address Mailing Address(number and street) CITY OF CARMEL 2 CIVIC SQ City`, State ZIP Code BMV Use Only CARMEL IN 46032-7543 Holder of Second Lien,Mortgage,or Other Encumbrance Mailing Address(number and street) City State ZIP Code License Number License Year Forms Use FBMV Use Only LA Gross Retail and Use Tax Affidavit-IANe 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 li I III VIII II II it II II II IIII IIIA I I VIII 11111 VIII II 2 0 5 3 0 2 5 9 4 6 0 9 CUSTOMER COPY State Form 48099(R5f7-q Approved by State Board of INDIANA CERTIFICATE OF VEHICLE REGISTRATION " Accounts 2017 CLASS I AGE I ISSUE DATE FUR DATE COUNTY TP I PL YR PLATE PL TP I WEIGHT I PR YR LS I TYPE I PRIOR YR PL 12/06/2018 10/31/2018 29-HAMILTON N 17 MID N EXPIRATION DATE MUNICIPALITY VEHICLE YEAR MAKE MODEL I VEHICLE IDENTIFICATION NUMBER I TYPE I COLOR NO EXP 2018 FOR EXP 1 FM5K8D89JGC83176 TK WHI/ CURRENT VEHEXTAX EX CREDIT DAV CREDIT NET EX TAX CO.WHEEUEX TAX IUN.WHEEL/EX TAX 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 VEH EX TAX EX CREDIT DAV CREDIT NEI EA I AA CO.WHEEL/EX TAX MUN.WHEEUEX TAX 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 2 CIVIC SQ N N LA CARMEL, IN 46032-7543 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