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173879 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 155400 Page 1 of 1 ONE CIVIC SQUARE INDIANA STATE BAR ASSOC CHECK AMOUNT: $240.00 s, to CARMEL, INDIANA 46032 ONE INDIANA SQUARE, SUITE 530 INDIANAPOLIS IN 46204 -2199 �o CHECK NUMBER: 173879 CHECK DATE: 6/24/2009 DEPART ACCOUNT PO NUMBER INVOICE NUMBER A MOUNT DESCRIPTION 1160 4355300 240.00 HECK BAR DUES S� ♦y INDIANA STATE BAR ASSOCIATION ,t METHOD OF PAYMENT (CHECK ONE BOX) 41 :7t* DUES NOTICE July 1, 2009 June 30 2010 VISA MASTERCARD AMERICAN EXPRESS DISCOVER ONE INDIANA SQUARE, SUITE 530 CARD NUMBER INDIANAPOLIS, IN 46204 -2199 317 639 -5465 800 266 -2581 Fax: 317-266-2588 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 e -mail: isbaadmin @inbar.org EXP. DATE YOU MAY PAY DUES ONLINE UPDATE El El 1:1 YOUR MEMBERSHIP INFORMATION SIGNATURE Verification Code www.inbar.or CHECK Q payable to: Indiana State Bar Association 29235 Automatic Credit Card Renewal Option: By initialing here, your Nancy S. Heck a dues will automatically be charged to your credit card May 1st of each year i,' of Carmel u 2 at the appropriate dues rate in existence for the ISBA at the time of renewal. Ci ty j�I To cancel your automatic renewal, members must notify the ISBA 10 days One Civic Square prior to the renewal date. Carmel, IN 46032 Regular Dues (6 yrs or over) 230.00 Governmental Practice Section 10.00 Vn� f...., ToC r •F, f• �atrirr�. ADDRESS; E -MAIL, PHONE& FAX ON CHANGES IN SECTION ENROLLMENTS: Please o untary l3arpac Con rl indicate with an X any section you wish to add. Add new dues Total J below. AGRICULTURAL LAW $20 ALTERNATIVE DISPUTE RESOLUTION $20 APPELLATE PRACTICE $20 /J O Q BANKRUPTCY CREDITORS' RIGHTS $30 Amount Paid: G BUSINESS LAW $10 CONSTRUCTION SURETY $20 CORPORATE COUNSEL $10 CRIMINAL JUSTICE $20 ELDER LAW $20 EMPLOYMENT LABOR LAW $20 ENVIRONMENTAL LAW $25 FAMILY JUVENILE LAW $15 GENERAL PRACTICE, SOLO SMALL FIRM $15 GOVERNMENTAL PRACTICE $10 HEALTH LAW $15 INTELLECTUAL PROPERTY $10 INTERNATIONAL LAW $15 LAND USE ZONING $15 LITIGATION $15 PLEADS Prof. Legal Ed., Admissions Development) $15 PROBATE, TRUST REAL PROPERTY $20 SENIOR LAWYERS $15 TAXATION $25 UTILITY LAW $20 YOUNG LAWYERS Tin INCLUDE THIS PORTION WITH REMITTANCE. See reverse side for important information regarding tax deductions. 29235 Nancy_S. Heck r City of Ca m'el C'1 i r, 11'f ,j 1 n c One Civic Square Total 29b.00 Carmel, IN 46032 See reverse side for important information regarding tax deductions. f Please complete ONLY of the front has changed! PLEASE UPDATE YOUR E -MAIL ADDRESS, PHONE AND FAX. E -MAIL ADDRESS PHONE NUMBER FAX NUMBER HOME OFFICE Membership Dues and Section Dues are not tax deductible as charitable contributions, but a portion may be tax deductible under other provisions CITY STATE ZIP of the Internal Revenue Code. This year, $3.00 of your dues were used for lobbying expenses and may not be tax deductible. The Indiana Bar Foundation is a 501(c)(3) organization. The $40.00 listed FIRM, EMPLOYER NAME OR PUBLIC OFFICE is a charitable contribution. BARPAC is a political action committee. The $10.00 contribution listed is voluntary and not tax deductible. Members of the judiciary are not AREA OF PRACTICE expected to contribute to BARPAC. (See Canon 4, Indiana Code of Judicial Conduct.) $5.00 is allocated from your dues payment for your Res Gestae PLEASE CHECK THE APPROPRIATE BOXES. subscription. a. FEMALE b. MALE 1. AFRICAN AMERICAN 2. AMERICAN INDIAN VD ASIAN 4. CAUCASIAN 5. HISPANIC 6.0 OTHER Membership Dues and Section Dues are not tax deductible as charitable INDIANA STATE BAR ASSOCIATION contributions, but a portion may be tax deductible under other provisions DUES NOTICE of the Internal Revenue Code. This year, $3.00 of your dues were used for lobbying expenses and may not be tax deductible. JUIy 1, 2009 June 30, 2010 The Indiana Bar Foundation is a 501(c)(3) organization. The $40.00 listed ONE INDIANA SQUARE, SUITE 530 is a charitable contribution. INDIANAPOLIS, IN 46204 -2199 317 639 -5465 800- 266 -2581 Fax: 317-266-2588 BARPAC is a political action committee. The $10.00 contribution listed is e-mail: isbaadmin @inbar.org voluntary and not tax deductible. Members of the judiciary are not YOU MAY PAY DUES ONLINE &UPDATE expected to contribute to BARPAC. (See Canon 4, Indiana Code of Judicial Conduct.) YOUR MEMBERSHIP INFORMATION: $5.00 is allocated from your dues payment for your Res Gestae www.inbar.org subscription. Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER 6/22/09 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 In diana State Bar Asso. Purchase Order No. 0�7ie Indiana Ste 530 Terms I ndianapolis IN 46204 -2199 Date Due Invoice Invoice Description Amount Date Number (or note attached Invoice(s) or bill(s)) Stmt Dues 7/1/09 thru 6/30/10 for Nancy Heck $240.00 Total $240.00 1 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. 6/22/09 ALLOWED 20 .Indiana State Bar Asso IN SUM OF One Indiana Sguare, Ste 530 Indianapolis IN 46204 -2199 240.00 ON ACCOUNT OF APPROPRIATION FOR 1160 Mayor 4355300 Organization membership dues Board Members Pp# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or Stmt 4355300 $240.00 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 20 J Signature Cost distribution ledger classification if Title claim paid motor vehicle highway fund