HomeMy WebLinkAbout212941 09/25/2012 a"�R CITY OF CARMEL, INDIANA VENDOR: 366537 Page 1 of 1
ONE CIVIC SQUARE TONI BUTLER
CARMEL, INDIANA 46032 C/O LEGAL CHECK AMOUNT: $6.12
CHECK NUMBER: 212941
CHECK DATE: 9/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
209 4358300 637651 6 . 12 OTHER FEES & LICENSES
Indiana Payment Portal Page 1 of 1
Your transaction is complete
Your transaction is complete. Print this receipt for your records. Your receipt identification number
is 3562389. Please reference this number in any correspondence regarding your transaction.
Payer Information ?
TONI BUTLER
`'
Phone
Email : tbutler @carmel.in.gov
Account Information ?
Transaction Details
Description Unit Quantity xtended
Price y Price
Notary Application Fee $5.00 1 $5.00
Instant Access Fee $1.12 1 $1.12
Total : $6.12
The following amounts have been charged to your credit card. Your credit card statement will show
the following merchant name(s) and amount(s) for this transaction.
Merchant Amount
IN Sec of State 800-236-5446 $6.12
The total amount charged to your credit card is $6.12.
Privacy Statement
1 E
1,ff„e•//c!.,,-nrPin F97(179C".7 9/1 IV?()17
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.7995)
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
Toni G. Butler
Purchase Order No.
2508 Bradford Avenue Terms
Kokomo, Indiana 46902 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9-18-12 Reimburse Toni G. Butler for monies she personally expended $6.12
for Indiana Notary Public Commission per the attached receipt
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 $6.12
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
ni (,. R,altar IN SUM OF
2508 Bradford Avenue
Kokomo, Indiana 46902
$ $6.12
ON ACCOUNT OF APPROPRIATION FOR
Deferral Fee Fund
430-58300 Other Fees & Licenses
Board Members
DEPT`f' INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s), or
209 637651 $6.12 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
- Si atu
Cost distribution ledger classification if itle
claim paid motor vehicle highway fund