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Home My WebLink About195861 03/29/2011 CITY OF CARMEL, INDIANA VENDOR: 00351564 Page 1 of 1 ONE CIVIC SQUARE GARY CARTER CHECK AMOUNT: $30.00 CARMEL, INDIANA 46032 4748BISHOPSCATE DR o io CARMEL IN 46032 CHECK NUMBER: 195861 CHECK DATE: 312912011 DEPARTMENT ACCOUNT P O NUMBER INVOICE NUMBER A MOU N T DESCRIPTION 1120 4358300 30.00 OTHER FEES LICENSES E Bureau of Motor Vehicles 11111111111111111111111 Illll Transaction Receipt Mil State Form 51717 (4 -04) Branch: VEHICLE SERVICES REGISTRATIONS Date: 3111111 Time: 1:48:19 pm EDT Visit ID: 16450374 Your Visit Time Today: Visit Customer: CITY OF CARMEL Transaction Time 00:20:55 Total time Hrs.Min.Sec 00:20:55 Transactions Trans ID Trans Ty Trans Subtype A mount 189460627 Title Initial Title Issuance New $15.00 189461259 Registration New Motor Vehicle Registration New $0.00 189461408 Title Initial Title Issuance r New $15.00 189462467 Registration New Motor Vehicle Registration New $0.00 Subtotal: $30.00 Sales /Use Tax: $0.00 Total: $30.00 Payment Method Amount DIL Number Authorization Number Name CREDIT $30.00 044878 Total Due: $30.00 Amount Paid: $30.00 Change Due: $0.00 Please help us improve our service by completing a one minute customer satisfaction surrey. Your responses are completely confidential. Visit http: /lwww.in.gov /bmvsurvey /start and enter the survey code 164650374 to get started. Thank you. If you have questions or comments, please call our Customer Service- Center at 888- myBMV411. Page 1 of 1 IIIIIlil11111111fllllllll IIIIIIII( Illllllllllllllllllllllllllllll 5 1 7 1 7 1 6 9 4 6 2 4 6 7 �lilllllllllllllllllillllllllllllll (Ifllllllll E B ureau of !Motor Vehicles 5 Detailed Tr ansaction Receipt BMV, State Form 51714 (4 -04) Branch: VEHICLE SERVICES REGISTRATIONS Date: 03/11/2011 Time: 13:48 EDT Visit ID: 164650374 CSR: SL Visit Customer: CITY OF CARMEL Transactions Trans IDTrans Type Trans Subtype Amount 189460627 Title Initial Title Issuance New Title Fee Vehicle $15.00 Vehicle: 1FMJU1J56BEF29074 2011 FOR EPT UT Lien Holder: None Customer: CITY OF CARMEL Purchase Date: 02/24/2011 189461408 Title Initial Title Issuance New Title Fee Vehicle $15.00 Vehicle: 1FMJUIJ58BEF29075 2011 FOR EPT UT Lien Holder: None Customer: CITY OF CARMEL Purchase Date: 02/28/2011 $30.00 Charges to your credit card will appear as a line item charge not as a total transaction charge. Page 1 of 1 APPLICATION FOR CERTIFICATE OF TITLE STATE OF INDIANA BUREAU OF MOTOR VEHICLES State Form 205 (R7 16-04) Approved by State Board of Account 1997 To BE COMPLETED BY A POLICE OFFICER, BMV OFFICIAL OR BMV CERTIFIED DEALER SIGNEE IIWETHEUNDERSIGNEDSWEARORAFFIRMTHATTHEINFORMA- FOROUT OF STATE TITLES. I HEREBY CERTIFY THAT I PERSONALLY EXAMINED THE FOLLOWING TION ENTERED ON THIS FORM IS CORRECT. IMIEUNDERSTAND VEHICLE ANDFINDTHE IDENTIFICATION NUMBERTO BE AS FOLLOWS. THAT MAKING A FALSE STATEMENT ON THIS FORM MAY CONSTI- VEHICL IDENTIFICATION JUMBER TUTE THE CRIME OF PERJURY, FUTHERMORE, I/WE AGREE TO INDEMNIFY AND HOLD HARMLESS THE INDIANA BMV FROM ANY LIABILITY ARISING FROM THIS TRANSACTION. R MAKE MODEL TYPE DATE x X INSPECTOR'S PRINTED NAME TITLE CITY DATE: INSPECTOR'S SIGNATURE BADGE, BRANCH OR The law requires that you apply for Certificate of Title within lhiny -one days from the dateof purchase ofa motor vehicle. There is a delinquent fee of $21.00 for failure to do so. Attach certificate of Title assigned by seller. Cn en- DEALER PLATE NO. dorsed TAIes, liens must 4e reloesed- Supporting documents surrendered with this application cannot be returned to the applF cauL State fee for applying for Title is S15.00. *In accordance with Federal Code 387. TITLE NUMBER BRANCH NO INVOICE NO BMV USE ONLY 1. 03111180300022 803 MV- GOVERNMENT CERTIFICATE OF ORIGIN 'SOC. SEC.IFEDERAL I.D. NO APPLICANT'S NAME BMV USE ONLY D 2. CITY OF CARMEL D STREET ADDRESS CITY STATE ZIP CODE N 3. 3 CIVIC SQ CARMEL IN 46032 -2584 D VEHICLE I.D. NUMBER VEH YEAR VEH. MAKE VEH MODEL NO. VEH. TYPE ODOMETER ACTUAL T 4- 1FMJU1J568EF29074 2011 FOR EPT 4W 5 M T FORMER TITLE NUMBER PURCHASE DATE LIEN SPEED PICK UP MAIL DEALER NO. BMV USE ONLY Y 5. C OF O 02/24/2011 5 No No Yes P E FIRST LIEN'S NAME OR SPECIAL MAILING ADDRESS STREET ADDRESS 6- CITY OF CARMEL 2 CIVIC SQ I N CITY STATE ZIP CODE i BMV USE ONLY 7 CARMEL IN 46032 -2584 T H SECOND LIEN'S NAME STREET ADDRESS 8. S CITY STATE ZIP CODE LICENSE NUMBER LI FORMS BMV USE ONLY A 9. USED SL R E GROSS RETAIL USE TAX AFFIDAVIT I/WE HEREBY CERTIFY THAT SALES OR USE TAX ON THIS VEHICLE WAS PAID AS INDICATED BELOW A SELLING PRICE LESS TRADE -IN I DISCOUNT AMOUNT SUBJECT TO TAXA(NI�NT O TAX DEALER BRAN H EXEMPT IF EXEMPT 1 0. 0.00 0.00 0.00 0.00 X PLACE 1 ARA.# 'Your Social Security number/ Federal I.D. number is being requested by this agency under IC 4 -1 -8-1. Disclosure is mandatory and this document cannot be processed without it. APPLICANT RESPONSIBLE FOR ACCURACY OF INFORMATION APPLICATION FOR CERTIFICATE OF TITLE STATE OF INDIANA BUREAU OF MOTOR VEHICLES 2 0 5 1 8 9 4 6 0 6 2 7 APPLICATION FOR CERTIFICATE OF TITLE STATE OF INDIANA BUREAU OF MOTOR VEHICLES State Form 205 (R7I6 -04) Approved by State Board of Account 1997 TO BE COMPLETED BY A POLICE OFFICER, BMV OFFICIAL OR BMV CERTIFIED DEALER SIGNEE IANE THE UNDERSIGNED SWEAR OR AFFIRM THAT THE INFORMA- FOR OUT OF STATE TITLE$. I HEREBY CERTIFY THAT I PERSONALLY EXAMINED THE FOLLOWING TIO4 ENTERED ON THIS FORM IS CORRECT. I/WE UNDERSTAND VEHICLE AND FIND THE IDENTIFICATION NUMBER TO BE AS FOLLOWS. T1IAT MAKING A FALSE STATEMENT ON THIS FORM MAY CONSTI- VEHICLE IDENTIFICATION 4UMBER TUTE THE CRIME OF PERJURY. FUTHERMORE, IlWE AGREE TO INDEMNIFY AND HOLD HARMLESS THE INDIANA BMV FROM ANY R MAKE MODEL TYPE DATE LIABILITY ARISING FROM THIS TRANSACTION. X X INSPECTOR'S PRINTED NAME TITLE CITY DATE: INSPECTOR'S SIGNATURE BADGE, BRANCH R The law requires that you apply for Certificate of Title within thirty -one days from the dale of purchase of a motorvehiele. There is a delinquent fee of $21.00 for failure to do so. Attach Cerlificate of Title assigned by seller. On en- DEALER PLATE NO. domed Titles, liens must be released_ Supporting documents surrendered with this application cannot I>e returned to the apple cant. Stale fee for applying for Title is $15.00. 'In accordance with Federal Code780. TITLE NUMBER BRANCH NO INVOICE NO BMV USE ONLY 1. 03111180300023 803 MV- GOVERNMENT- CERTIFICATE OF ORIGIN 'SOC. SEC. /FEDERAL I.D. NO APPLICANT'S NAME BMV USE ONLY D 2. CITY OF CARMEL 0 STREET ADDRESS CITY STATE ZIP CODE N 3. 3 CIVIC SQ CARMEL IN 46032 -2584 0 VEHICLE I.D. NUMBER VEH. YEAR VEH. ACTUAL MAKE VEH. MODEL NO. VEH. TYPE ODOMETER T 4. 1FMJUIJ58BEF29075 2011 FOR EPT 4W 5 T FORMER TITLE NUMBER PURCHASE DATE LIEN SPEED PICK UP MAIL DEALER NO. BMV USE ONLY Y P C OF O 02/28/2011 5 No No Yes E FIRST LIEN'S NAME OR SPECIAL MAILING ADDRESS STREET ADDRESS 6. CITY OF CARMEL 2 CIVIC SQ N CITY STATE ZIP CODE BMV USE ONLY 7. CARMEL IN 46032 -2584 T H SECOND LIEN'S NAME STREETADDRESS I 6. S CITY STATE ZIP CODE LICENSE NUMBER LI FORMS BMV USE ONLY A 9 USED SL R E GROSS RETAIL USE TAX AFFIDAVIT- INVE HEREBY CERTIFY THAT SALES OR USE TAX ON THIS VEHICLE WAS PAID AS INDICATED BELOW A SELLING PRICE LESS TRADE-IN I DISCOUNT AMOUNT SUBJECT? TAXAMOUNT O TAX DEALER BRANCH EXEMPT IF EXEMPT PLACE PARA.# 10. 0.0c) 0.00 0.00 0.00 X 1 Your Social Security number! Federal I D. number is being requested by this agency under IC 4- 1-8 -1. Disclosure is mandatory and this document cannot be processed without it. APPLICANT RESPONSIBLE FOR ACCURACY OF INFORMATION APPLICATION FOR CERTIFICATE OF TITLE STATE OF' INDIANA BUREAU OF MOTOR VEHICLES {I{ {I {{II {11111 Illlllllllllllllllll [1111IIIIIIlI1111II 2 0 5 1 8 9 4 6 1 4 0 8 Bureau of Motor Vehicles Registration Fees Detailed Receipt BII State Form 51718 (4 -04) e i Branch: rVgEH31ICLE SERVICES REGISTRATIONS Date: 03/11/2011 Time: 13:27 EDT Visit ID: '164650374 Tran ID: 189461259 Visit Customer: CITY OF CARMEL STARS Trans 03111180300030 Transaction Type: New Motor Vehicle Registration Registration License Type: MUNICIPAL OWNED PlatelPermitlRegistration Number: Vehicle Identification Number: 1FMJU1J56BEF29074 Registration Year Fee Type Subtotal Total 2010 NONE (NONE) 2010 $0.00 CITY OF CARMEL Total NONE (NONE) 2010: $0.00 Organ Donation $0.00 Total for 2010: 0.00 Transaction Total: 0.00 Charges to your credit card will appear as a line item charge not as a total transaction charge. Page 1 of 1 Bureau of Motor Vehicles 3 E v Registration Fees Detailed Receipt State Form 51718 (4 -04) BM1l� E Branch: VEHICLE SERVICES REGISTRATIONS Date: 03/11/2011 Time: 13:27 EDT Visit ID: 64650374 Tran ID: 189462467 Visit Customer:. CITY OF CARMEL STARS Trans 03111180300032 Transaction Type: New Motor Vehicle Registration Registration License Type: MUNICIPAL OWNED PlatelPermitlRegistration Number: Vehicle Identification Number: 1FMJU1J58BEF29075 Registration Year Fee Type Subtotal Total 2010 NONE (NONE) 2010 $0.00 CITY OF CARMEL Total NONE (NONE) 2010: $0.00 Organ Donation $0.00 Total for 2010: 0.00 Transaction Total: 0.00 Charges to your credit card will appear as a line item charge not as a total transaction charge. Page 1 of 1 VOUCHER NO. WARRANT NO. ALLOWED 20 Gary Carter IN SUM OF $30.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #!TITLE I AMOUNT Board Members 1120 I f 43- 583.00 I $30.00 1 hereby certify that the attached invoice(s), or 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 MAR 2 8 2011 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL 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. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Two New Expeditions 9075 9075 $30.00 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 20 Clerk- Treasurer