161507 07/11/2008 CITY OF CARMEL, INDIANA VENDOR: 358229 Page 1 of 1
ONE CIVIC SQUARE NICOLE PASSINEAU CHECK AMOUNT: $16.00
C/O ROCS
CARMEL, INDIANA 46032
CHECK NUMBER: 161507
CHECK DATE: 7/11/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 4357004 16.00 EXTERNAL INSTRUCT FEE
Bureau of Motor Vehicles IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
Transaction Receipt
5, $MV State Form 51717 (4 -04)
Branch: CARMEL STARS (527) Date: 6/25/08 Time: 2:12:12 pm EDT
Visit ID: 142184334 Visit Duration: 00:03:01
Visit Customer Visit Duration is the time elapsed from check in to
transaction completion.
NICHOLE MARIE PASSINEAU This time does not include testing time.
PO BOX 831
CICERO, IN 46034 -0831
Transactions
Trans ID Trans Type Trans Subtype Amount
153617144 Driver Renew CDL Permit Renew $16.00
Subtotal: $16.00
Sales /Use Tax: $0.00
Total: $16.00
Payment Method Amount DL Number Authorization Number Name
CREDIT $16.00 230578
Total Due: $16.00
Amount Paid: $16.00
Change Due: $0.00
Charges to your credit card will appear as a line item charge not as a total transaction charge. Page 1 of 1
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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))
00
Total /�p, d G
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
,DOGS
00V cG
ON ACCOUNT OF APPROPRIATION FOR
(S
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
q
510. 0 q 16-00 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
7,/7 2008
Signat e QO
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund