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Home My WebLink About220663 06/04/2013 CITY OF CARMEL, INDIANA VENDOR: 155400 Page 1 of 1 ONE CIVIC SQUARE INDIANA STATE BAR ASSOC CHECK AMOUNT: $320.00 CARMEL, INDIANA 46032 ONE INDIANA SQUARE,SUITE 530 INDIANAPOLIS IN 46204-2199 CHECK NUMBER: 220663 CHECK DATE: 6/4/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1180 4355300 320 . 00 ORGANIZATION & MEMBER * * INDIANA STATE BAR ASSOCIATION METHOD OF PAYMENT(CHECK ONE BOX) DUES NOTICE ❑ VISA ❑ MASTERCARD ❑ DISCOVER ® July 1, 2013 - June 30, 2014 ® � CARD NUMBER ONE INDIANA SQUARE, SUITE 530 ❑❑❑❑❑❑❑1:11:11:11:11:1❑❑❑❑ 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 CHECK g , payable to:Indiana State Bar Association Automatic Credit Card Renewal Option: . By initialing here, your 23811 dues will automatically be charged to your credit card July 1st of each year at the appropriate dues rate in existence for the ISBA at the time of renewal. Douglas C. Haney 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 Contributions- ee- CHANGES IN SECTION ENROLLMENTS: Please Voluntary BarpacCur'iiributiun r8 70-d— indicate with an X any section you wish to add. AGRICULTURAL LAW $20 Total 345.00 ALTERNATIVE DISPUTE RESOLUTION $20 ANIMAL LAW $15 APPELLATE PRACTICE $20 BANKRUPTCY&CREDITORS'RIGHTS $30 BUSINESS LAW $10 Amount Paid: 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 LAND USE&ZONING $15 LITIGATION $15 PLEADS(Prof. Legal Ed.,Admissions&Development) $20 PROBATE,TRUST&REAL PROPERTY $20 SENIOR LAWYERS $15 TAXATION $25 UTILITY LAW $20 YOUNG LAWYERS $15 (INCLUDE THIS PORTION WITH REMITTANCE. See reverse side for important information regarding tax deductions. 1 PLEASE UPDATE YOUR E-MAIL ADDRESS, PHONE, FAX AND OTHER DEMOGRAPHIC INFORMATION E-MAIL ADDRESS PHONE NUMBER FAX NUMBER ❑HOME ❑OFFICE T 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 $5.00 is allocated from your dues payment for your Res Gestae subscription. PLEASE CHECK THE APPROPRIATE BOXES. a.❑FEMALE b.❑MALE 1.❑AFRICAN AMERICAN 2.❑AMERICAN INDIAN 3.0 ASIAN 4.❑CAUCASIAN 5.❑ HISPANIC 61]OTHER INDIANA RETAIL TAX EXEMPT PAGE City o Carmel CERTIFICATE NO.003120155 002 0 11 PURCHASE ORDER NUMBER �-� FEDERAL EXCISE TAX EXEMPT !j I- 35-60000972 ;.5 3 '7 7 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE. FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION � " ,�!f�/: -CD�r✓ SHIP VENDOR b TO CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION f /t UNIT PRICE EXTENSION f y' C..�'f�'4,t•,rj�./�,•�r 1 !(,�.�C-�-�'� �0� ,�tl�/��% � �.c!s�-� c ..C" Send Invoice To: " t d PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT PAYMENT }% 3pZL"r C�G3 A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. • •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. •PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. (� ` •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 3 2 ( CLERK-TREASURER DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO.__-__.WARRANT NO.-._A_`. ALLOWED 20 IN THE SUM OF$ .30 clil 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 D' 06 materials or services itemized thereon for which charge is made were ordered and received except oZ 20/__3 Title + I Cost distribution ledger classification if claim paid motor vehicle highway fund