220199 05/21/2013 CITY OF CARMEL, INDIANA VENDOR: 155400 Page 1 of 1
ONE CIVIC SQUARE INDIANA STATE BAR ASSOC
o CARMEL, INDIANA 46032 ONE INDIANA SQUARE,SUITE 530 CHECK AMOUNT: $295.00
INDIANAPOLIS IN 46204-2199 CHECK NUMBER: 220199
CHECK DATE: 5/2112013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1203 4355300 DUES—HECK 295 . 00 ORGANIZATION & MEMBER
INDIANA STATE BAR ASSOCIATION METHOD OF PAYMENT(CHECK ONE BOX)
DUES NOTICE
El
VISA ❑ MASTERCARD ❑ DISCOVER
® ® July 1; 2013 - June 30, 2014
CARD NUMBER
ONE INDIANA SQUARE, SUITE 530 ❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑❑
INDIANAPOLIS, IN 46204-2199 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
317-639-5465 800-266-2581 Fax: 317-266-2588
e-mail: isbaadmin @inbar.org EXP.DATE
YOU MAY PAY DUES ONLINE& UPDATE SIGNATURE ❑❑❑❑
YOUR MEMBERSHIP INFORMATION Verification Code
UNTIL 9-30-13: www.inbar.or E] CHECK
g payable to:Indiana State Bar Association
Automatic Credit Card Renewal Option: . By initialing here, your
29235 dues will automatically be charged to your credit card July 1st of each year
Nancy S. Heck at the appropriate dues rate in existence for the ISBA at the time of renewal.
To cancel your automatic renewal, members must notify the ISBA 10 days
City of Carmel prior to the renewal date.
One Civic Square
Carmel, IN 46032
Regular Dues(6 yrs or over) 280.00
Governmental Practice Section 15.00
ADDRESS,E-MAIL,PHONE&FAX CORRECTIONS REQUESTED ON BACK Voluntary IBF Contribution - —
CHANGES IN SECTION ENROLLMENTS: Please Voluntary Barpac Contribution ee- -
indicate with an X any section you wish to add.
AGRICULTURAL LAW $20 Total
ALTERNATIVE DISPUTE RESOLUTION $20 _
ANIMAL LAW $15
APPELLATE PRACTICE $20
BANKRUPTCY&CREDITORS'RIGHTS $30 G f�
BUSINESS LAW $10 Amount Paid: I
CONSTRUCTION&SURETY $20
CORPORATE COUNSEL $10
CRIMINAL JUSTICE $20
ELDER LAW $20
EMPLOYMENT&LABOR LAW $25
ENVIRONMENTAL LAW $25
FAMILY&JUVENILE LAW $15
GENERAL PRACTICE,SOLO&SMALL FIRM $25
GOVERNMENTAL PRACTICE $15
HEALTH LAW $15
INTELLECTUAL PROPERTY $10
INTERNATIONAL LAW $15 t
LAND USE&ZONING $15 lJ Y'gC(n12Q-h� C.� yuj Vl�oln'v�Y �-4
LITIGATION $15 V' �L
PLEADS(Prof.Legal Ed.,Admissions&Development) $20il
PROBATE,TRUST&REAL PROPERTY $20
SENIOR LAWYERS $15 `-
TAXATION $25 /
UTILITY LAW $20
YOUNG LAWYERS $15
See reverse side for important information regarding tax deductions. INCLUDE THIS PORTION WITH REMITTANCE.
PLEASE UPDATE YOUR E-MAIL ADDRESS, PHONE, FAX
AND OTHER DEMOGRAPHIC INFORMATION
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, 5%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 voluntary charitable contribution.
BARPAC is a political action committee.The$10.00 contribution listed is
voluntary and not tax deductible.
AREA OF PRACTICE
$5.00 is allocated from your dues payment for your Res Gestae
subscription.
PLEASE CHECK THE APPROPRIATE BOXES.
a.❑FEMALE b.❑MALE
1.0 AFRICAN AMERICAN 2.0 AMERICAN INDIAN 3.❑ASIAN
4.❑CAUCASIAN 5.El HISPANIC 6.E]OTHER
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Dues Notice $295.00
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.
ALLOWED 20
Indiana State Bar Association
IN SUM OF $
One Indiana Square, Suite 530
Indianapolis, IN 46204-2199
$295.00
ON ACCOUNT OF APPROPRIATION FOR
Community Relations
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1203 Dues Notice 43-553.00 $295.00
I hereby certify that the attached invoice(s), or
I I
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
Friday, May 17, 2013
Gt�GtG�, �`---
Director, Cqmmunity Relations/Economic Development
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund