HomeMy WebLinkAbout172377 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: L2370 Page 1 of 1
ONE CIVIC SQUARE INDIANA STATE CENTRAL COLLECTIO'6ECK AMOUNT: $440.00
CARMEL, INDIANA 46032 UNIT ASFE
PO BOX 6271 CHECK NUMBER: 172377
INDIANAPOLIS IN 46206 -6271
CHECK DATE: 5/13/2009
DEP ARTME NT ACCOUNT PO NUMBER INVO NUMBER AMOUNT DESCRIPTION
101 5023990 440.00 CHILD SUPPORT COLL FE
PLEASE RETAIN THIS PORTION FOR YOUR RECORDS
CAUSE NUMBER ISETS CASE NUMBER ASFE AMOUNT
49D03-9306 -DR -1114 0005157675 $55.00
i
Total ASFE Due for above listed cases $55.00
ASFE Notice: State Form 53234(11- 07)CAS00045 Approved by State Board of Accounts, 2007
°lease note that the Indiana General Assembly set the amount of the fee at $55
effective January 1, 2008. Employers please note: In instances where the Child
Support Bureau does not have the address of the non custodial parent (NCP),
this notice is sent in care of the NCP's employment record. Employers are asked
to forward this notice to your employee, or inform the Child Support Bureau that
the NCP is no longer employed with you.
4 Dear PAUL V. PACE
This notice is to inform you that pursuant to IC 33- 37 -5 -6 and IC 31- 16 -15, the
2009 Annual Support and Maintenance Docket Fee (ASFE) for the listed child support
case(s) shown on the coupon attached below is due by 04/30/2009. $55.00 is due
for each and every individual case. In order to assure proper credit, you must
include the coupon below when Paving the fee In addition, please remember to
write on Your check or money order your Social Security Number (SSN) and clearly
note that it is for the ASFE
DO NOT combine your ASFE payment with a child support payment or you may not
receive proper credit for payment of this fee. This is the only notice you will
receive for the current fee for this calendar year. If the total amount shown is
not received by 04/30/2009, an Income Withholding Order will be sent to your
employer to withhold the balance owed for the current year's fee for each and
every individual case eligible for income withholding. If you have any questions
about this notice, please contact the Kids Line at (317)233 -5437 or (800)840 -8757.
Please note, you may also receive an ASFE notice from your County Clerk's office
regarding any past due ASFE balances from previous years. Please contact the
County Clerk about these notices.
Thank you.
Cynthia Longest
Deputy Director
Department of Child Services
Child Support Bureau
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PLEASE RETAIN THIS PORTION FOR YOUR RECORDS
CAUSE NUMBER ISETS CASE NUMBER ASFE AMOUNT
29D02- 9704 -DR -0233 0001446753 $55.00
Total ASFE Due for above listed cases $55.00
ASFE Notice: State Form 53234(11- 07)CAS00045 Approved by State Board of Accounts, 2007
Please note that the Indiana General Assembly set the amount of the fee at $55
effective January 1, 2008. Employers please note: In instances where the Child
Support Bureau does not have the address of the noncustodial parent (NCP),
-;pis notice is sent in care of the NCP's employment record. Employers are asked
to forward this notice to your employee, or inform the Child Support Bureau that
the NCP is no longer employed with you.
Dear DAVID MARTIN
This notice is to inform you that pursuant to IC 33- 37 5 -6 and IC 31 16 -15, the
2009 Annual Support and Maintenance Docket Fee (ASFE) for the listed child support
case(s) shown on the coupon attached below is due by 04/30/2009. $55.00 is due
for each and every individual case. In order to assure proper credit, you mus
include the coupon below when paving the fee In addition, please remember to
!rite gn Your check or money order your Social Security Number (SSN) and clearly
note that it is for the ASFE
DO NOT combine your ASFE payment with a child support payment or you may not
receive proper credit for payment of this fee. This is the only notice you will
receive for the current fee for this calendar year. If the total amount shown is
not received by 04/30/2009, an Income Withholding Order will be sent to your
employer to withhold the balance owed for the current year's fee for each and
every individual case eligible for income withholding. If you have any questions
about this notice, please contact the Kids Line at (317)233 5437 or (800)840 -8757.
Please note, you may also receive an ASFE notice from your County Clerk's office
regarding any past due ASFE balances from previous years. Please contact the
County Clerk about these notices.
Thank you.
har
f-
Cynthia Longest
Deputy Director
Department of Child Services
Child Support Bureau
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PLEASE RETAIN THIS PORTION FOR YOUR RECORDS
CAUSE NUMBER ISETS CASE NUMBER ASFE AMOUNT
29C01- 9410 -DR -0742 0002479753 555.00
Total ASFE Due for above listed cases $55.00
ASFE Notice: State Form 53234(11- 07)CAS00045 Approved by State Board of Accounts, 2007
Please note that the Indiana General Assembly set the amount of the fee at $55
effective January 1, 2008. Employers please note: In instances where the Child
Support Bureau does not have the address of the non custodial parent (NCP),
this notice is sent in care of the NCP's employment record. Employers are asked
to forward this notice to your employee, or inform the Child Support Bureau that
the NCP is no longer employed with you.
Dear THOMAS PAYNE
This notice is to inform you that pursuant to IC 33- 37 -5 -6 and IC 31- 16-15, the
2009 Annual Support and Maintenance Docket Fee (ASFE) for the listed child support
case(s) shown on the coupon attached below is due by 04/30/2009. $55.00 is due
for each and every individual case. In order to assure proper credit, you must
include the coupon below when Paving the fee In addition, please remember to
write on your check or money order your Social Security Number (SSN) and clearly
note that it is for the ASFE
DO NOT combine your ASFE payment with a child support payment or you may not
receive proper credit for payment of this fee. This is the only notice you will
receive for the current fee for this calendar year. If the total amount shown is
not received by 04/30/2009, an Income Withholding Order will be sent to your
employer to withhold the balance owed for the current year's fee for each and
every individual case eligible for income withholding. If you have any questions
about this notice, please contact the Kids Line at (317)233 -5437 or (800)840 -8757.
Please note, you may also receive an ASFE notice from your County Clerk's office
regarding any past due ASFE balances from previous years. Please contact the
County Clerk about these notices.
Thank you.
Cynthia Longest
Deputy Director
Department of Child Services
Child Support Bureau
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PLEASE RETAIN THIS PORTION FOR YOUR RECORDS
CAUSE NUMBER ISETS CASE NUMBER ASFE AMOUNT
29C01- 0205 -JP -0684 0004353249 $55.00
Total ASFE Due for above listed cases $55.00
ASFE Notice: State Form 53234(11- 07)CAS00045 Approved by State Board of Accounts, 2007
Please note that the Indiana General Assembly set the amount of the fee at $55
effective January 1, 2008. Employers please note: In instances where the Child
Support Bureau does not have the address of the non custodial parent (NCP),
this notice is sent in care of the NCP's employment record. Employers are asked
to forward this notice to your employee, or inform the Child Support Bureau that
the NCP is no longer employed with you.
Lear JOHN"W. MCALLTSTEk This notice is to inform you that pursuant to IC 33- 37 -5 -6 and IC 31- 16 -15, the
2009 Annual Support and Maintenance Docket Fee (ASFE) for the listed child support
case(s) shown on the coupon attached below is due by 04/30/2009. $55.00 is due
for each and every individual case. In order to assure proper credit, you must
include the coupon below when paving the fee In addition, please remember to
write on your check or money order your Social S ecurity Number N) and clearly
note that it is for the ASFE
DO NOT combine your ASFE payment with a child support payment or you may not
receive proper credit for payment of this fee. This is the only notice you will
receive for the current fee for this calendar year. If the total amount shown is
not received by 04/30/2009, an Income Withholding Order will be sent to your
employer to withhold the balance owed for the current year's fee for each and
every individual case eligible for income withholding. If you have any questions
about this notice, please contact the Kids Line at (317)233 -5437 or (800)840 -8757.
Please note, you may also receive an ASFE notice from your County Clerk's office
regarding any past due ASFE balances from previous years. Please contact the
County Clerk about these notices.
Thank you.
d
Cynthia Longest
Deputy Director
Department of Child Services
Child Support Bureau
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PLEASE RETAIN THIS PORTION FOR YOUR RECORDS
CAUSE NUMBER ISETS CASE NUMBER ASFE AMOUNT
29D04- 0007 -DR -0994 0003566540 $55.00
Total ASFE Due for above listed cases $55.00
ASFE Notice: State Form 53234(11- 07)CAS00045 Approved by State Board of Accounts, 2007
Please note that the Indiana General Assembly set the amount of the fee at $55
effective January 1, 2008. Employers please note: In instances where the Child
Support Bureau does not have the address of the non custodial parent (NCP),
this notice is sent in care of the NCP's employment record. Employers are asked
to forward this notice to your employee, or inform the Child Support Bureau that
the NCP is no longer employed with you.
Dear RANDY S. SCHALBURG
This notice is to inform you that pursuant to IC 33- 37 -5 -6 and IC 31 16 15, the
2009 Annual Support and Maintenance Docket Fee (ASFE) for the listed child suppor
case(s) shown on the coupon attached below is due by 04/30/2009. $55.00 is due
for each and every individual case. In order to assure proper credit, y-o_u_mu.s-t
include the coupon below when paving the fee In addition, please remember to
-wci -te—on your check or m on ey o l- der— y�u.r_QS_i�.l �€cs� Nu mbe�(_��NZans� �1ea.�lY
note that it is for the ASFE
DO NOT combine your ASFE payment with a child support payment or you may not
receive proper credit for payment of this fee. This is the only notice you will
receive for the current fee for this calendar year. If the total amount shown is
not received by 04/30/2009, an Income Withholding Order will be sent to your
employer to withhold the balance owed for the current year's fee for each and
every individual case eligible for income withholding. If you have any questions
about this notice, please contact the Kids Line at (317)233 -5437 or (800)840 -8757
Please note, you may also receive an ASFE notice from your County Clerk's office
regarding any past due ASFE balances from previous years. Please contact the
County Clerk about these notices.
Thank you.
ern- f
Cynthia Longest
Deputy Director
Department of Child Services
Child Support Bureau
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PLEASE RETAIN THIS PORTION FOR YOUR RECORDS
CAUSE NUMBER ISETS CASE NUMBER ASFE AMOUNT
80001- 0306 -DR -155 0004743048 $55.00
Total ASFE Due for above listed cases $55.00
ASFE Notice: State Form 53234(11- 07)CAS00045 Approved by State Board of Accounts, 2007
Please note that the Indiana General Assembly set the amount of the fee at $55
effective January 1, 2008. Employers please note: In instances where the Child
Support Bureau does not have the address of the non custodial parent (NCP),
this notice is sent in care of the NCP's employment record. Employers are asked
to forward this notice to your employee, or inform the Child Support Bureau that
the NCP is no longer employed with you.
Dear RANDY MASS 1 NGI CL
This notice is to inform you that pursuant to IC 33- 37 -5 -6 and IC 31- 16 -15, the
2009 Annual Support and Maintenance Docket Fee CAUFE) for the listed child support
case(s) shown on the coupon attached below is due by 04/30/2009. $55.00 is due
for each and every individual case. In order to assure proper credit, you must
include the coupon below when paving the fee In addition, please remember to
write on your check or money order your Social Security Number (SSN) and clearly
note that it is for the ASFE
DO NOT combine your ASFE payment with a child support payment or you may not
receive proper credit for payment of this fee. This is the only notice you will
receive for the current fee for this calendar year. If the total amount shown is
not received by 04/30/2009, an Income Withholding Order will be sent to your
employer to withhold the balance owed for the current year's fee for each and
every individual case eligible for income withholding. If you have any questions
about this notice, please contact the Kids Line at (317)233 -5437 or (800)840-8757.
Please note, you may also receive an ASFE notice from your County Clerk's office
regarding any past due ASFE balances from previous years. Please contact the
County Clerk about these notices.
Thank you.
Cynthia Longest
Deputy Director
Department of Child Services
Child Support Bureau
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PLEASE RETAIN THIS PORTION FOR YOUR RECORDS
CAUSE NUMBER ISETS CASE NUMBER ASFE AMOUNT
29D01- 0208 -DR -0621 0004843254 $55.00
Total ASFE Due for above l cases $55.00
ASFE Notice: State Form 53234(11- 07)CAS00045 Approved by State Board of Accounts, 2007
Please note that the Indiana General Assembly set the amount of the fee at $55
effective January 1, 2008. Employers please note: In instances where the Child
Support Bureau does not have the address of the non custodial parent (NCP),
this notice is sent in care of the NCP's employment record. Employers are asked
to forward this notice to your employee, or inform the Child Support Bureau that
the NCP is no longer employed with you.
Dear SCOTT L. BREWER
This notice is to inform you that pursuant to IC 33- 37 -5 -6 and IC 31 16 -15, the
2009 Annual Support and Maintenance Docket Fee (ASFE) for the listed child support
case(s) shown on the coupon attached below is due by 04/30/2009. $55.00 is due
for each and every individual case. In order to assure proper credit, you must
include the coupon below when pavina the fee In addition, please remember to
write on your check or money order your Social Security Number (SSN) and clearl
note that it is for the ASFE
DO NOT combine your ASFE payment with a child support payment or you may not
receive proper credit for payment of this fee. This is the only notice you will
receive for the current fee for this calendar year. If the total amount shown is
not received by 04/30/2009, an Income Withholding Order will be sent to your
employer to withhold the balance owed for the current year's fee for each and
every individual case eligible for income withholding. If you have any questions
about this notice, please contact the Kids Line at (317)233 -5437 or (800)840 -8757.
Please note, you may also receive an ASFE notice from your County Clerk's office
regarding any past due ASFE balances from previous years. Please contact the
County Clerk about these notices.
Thank you.
Cynthia Longest
Deputy Director
Department of Child Services
Child Support Bureau
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PLEASE RETAIN THIS PORTION FOR YOUR RECORDS
CAUSE NU MBER ISETS CASE NUMBER ASFE AMOUNT
29D01- 9810 -DR -0614 0003454074 $55.00
Total ASFE Due for above listed cases $55.00
ASFE Notice: State Form 53234(11- 07)CAS00045 Approved by State Board of Accounts, 2007
Please note that the Indiana General Assembly set the amount of the fee at $55
effective January 1, 2008. Employers please note: In instances where the Child
Support Bureau does not have the address of the non custodial parent (NCP),
this notice is sent in care of the NCP's employment record. Employers are asked
to forward this notice to your employee, or inform the Child Support Bureau that
the NCP is no longer employed with you.
Dear AARON HOOVER
This notice is to inform you that pursuant to IC 33- 37 -5 -6 and IC 31- 16 -15, the
2009 Annual Support and Maintenance Docket Fee (ASFE) for the listed child suppor
case(s) shown on the coupon attached below is due by 04/30/2009• $55.00 is due
for each and every individual case. In order to assure proper credit, you must
include the coupon below when payina the fe In addition, please remember to
-write o n your check o-r mon order your_S -o S Number (SSN) and clearly
note that it is for the ASFE
DO NOT combine your ASFE payment with a child support payment or you may not
receive proper credit for payment of this fee. This is the only notice you will
receive for the current fee for this calendar year. If the total amount shown is
not received by 04/30/2009, an Income Withholding Order will be sent to your
employer to withhold the balance owed for the current year's fee for each and
every individual case eligible for income withholding. If you have any questions
about this notice, please contact the Kids Line at (317)233 -5437 or (800)840 -8757
Please note, you may also receive an ASFE notice from your County Clerk's office
regarding any past due ASFE balances from previous years. Please contact the
County Clerk about these notices.
Thank you.
6 r ,f.,' jn r
Cynthia Longest
Deputy Director
Department of Child Services
Child Support Bureau
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CHILD INDIAN
SERVICES
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EMPLOYEES W DED CODE FOR child support fee 149.xls
Ded
Emplo ucti Amt
yee on Deduct
Depart Numb Cod Current
ment er First Name Last Name a P ay
1120 67 GARY BRANDT 1 149 1 $2.00
1192 948 SCOTT LREWER`] 1.49 $2.00
1110 3 3 89 MATTHEW J BROADNAX 1149 I 2.00
2201 2363 TIM BROWNING 11
149 $2.00
2201 2364 MARK CARTER 1149 1 $2.00
111 902 WILLIE COLLINS 1 149 $2.00
112 7 31 DAVID CONTINO 1 149 $2.00
160 ANDREW CREASY 1 149 $2.00
1120 413 CARL JDRAKE 149 $2.00
1110 1 581 j DRIVER J 149_ 2.00
651 278 JOSEPH FAUCETT 149 1 5 2.0 0
1110 476 J 149 $2.00
1110 752IANDREW �GERDT 149 $2.00
1120 870 BRU 1GIPSON 114 4 9
1120 1 512 SAMUEL HAYMAKER
1601 643 AARON HOOVER Q 1 149 $2.00
110 2024 DANNY DENT f 149 52.00
2201 2192 RANDALL 1JOHNSON -J 149 $2.00
112 1039 TROY KELSHEIMER 149 $2.00
16 02 -I 760 ROBERT I LOVELL 149 $2.00
1120 I 294 1DAVID MARTIN T149 $2.00
16 841 RANDY �MASSINGILLJ 149 $2.00
1110 370 JOHN I MCALLISTER 1 149 2.00
1602 435 PAUL 1PACE 149 52.00
1110 3388 GREG (PARK 1149 $2.00
1120 741 THOMAS I PAYNE 1 149 $2.00
651 2629 ERIC ROBINSON j149 $2.00
1110 51 RANDY SCHALBURG '.J 149 2.00
1120 97 JAMES 1SPELBRING 149 $2.00
2201 2029 NATHAN STAPLETON 149 $2.00
1110 216 DAVID STRONG 1 149 $2.00
1120 414 f JAMES ITONEY 1 149 S 2.00
1120 747ITODD JUTZIG 1 149 1 $2.00
Pagel
Belcher, Jean
From: SupportNetProject@dcs.in.gov
Sent: Monday, March 30, 2009 9:27 AM
To: Belcher, Jean
Subject: CSB Employer Online Payment System
Good Morning Everyone,
Our office recently sent out notices to Non Custodial Parents (NCP) concerning the $55.00
ASFE due this year. If we did not have an address for the NCP, the notice was sent to the
NCP in care of the employer we had listed so that it could be given to the NCP.
IT the NCP does not pay the fee on their own by April 30th, an Income Withholding Order
(IWO) will be issue to the employer we have listed for them.
When the IWOs are created the Employer Online Payments System will then be able to access
the list of NCP's who still owe the fee and employers will then be able to pay the fees on line.
Until then employers will not be able to use the site to pay the fee.
If you don't want to wait for the IWO's to be created to pay the fee, you can send a check to
the address listed on the notice.
Have a great week.
Mary Francis, Supervisor
EFT Unit
Indiana State Child Support Bureau
Dept. of Child Services
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
//�S �C f sri✓� Purchase Order N
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
eZ
c
Total d
4 f
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in acco`r'dance
with IC 5- 11- 10-1.6.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
GAz37D
ALLOWED 20
SUM OF
C? 0X A. 7/
V6, o 6,; 7/
0 0
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
93 SS materials or services itemized thereon for
0 1 .z. :5Z which charge is made were ordered and
;2-9c -01- ad.L
JP 0 6 SS �0 received except
94D iOV- �d7 S 00
IDS
805 e961 0(3)ZS6 SS 00
0 2 5
�9 p 8 p
v. Ss
liz-q D 1 9 Fi10 S o
20.Q
ture
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund