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CHECK NUMBER: 171193
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REMITTANCE ADVICE DETACH AND RETAIN FOR YOUR RECORDS
PRESCRIBED BY STATE BOARD OF ACCOUNTS GENERAL FORM NO. 352
RECEIPT
98797
HAMILTON COUNTY AUDITOR
t
7 FUND
NOBLESVILLE, IN, 20
RECEIVED FROM
THE SUM OF DOLLARS
100
ON ACCOUNT OF
J 2 1173
PAID BY: ❑CASH mc
HECK ❑M.O. AUTHORIZED SIGNATURE
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))
Total
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
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
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
n
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund