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Home My WebLink About221449 07/02/2013 CITY OF CARMEL, INDIANA VENDOR: 00351564 Page 1 of 1 ONE CIVIC SQUARE GARY CARTER CARMEL, INDIANA 46032 4748 BISHOPSGATE DR CHECK AMOUNT: $30.00 CARMEL IN 46032 CHECK NUMBER: 221449 CHECK DATE: 7/2/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4358300 30 . 00 OTHER FEES & LICENSES k Bureau of Motor Vehicles �II�II�IIIIIIII�I(I�I �IIIIiiIIIlIIIIGIII��III �V A Customer Transaction Receipt III I(I II t State Form 51717 (4-04) � v Branch: VEHICLE SERVICES- REGISTRATIONS Date: 6119/13 Time: 11:08:11 am EDT Visit ID: (18919396 Your Visit Time Today: Visit Customer: CITY OF CARMEL Transaction Time 00:16:46 Total time 00:16:46 Hrs.Min.Sec Transactions Trans ID (PIN) Trans Type Trans Subtype Amount 222840598 Title-Initial Title Issuance New $15.00 222841224 Registration - New Motor Vehicle Registration New $0.00 222841686 Title- Initial Title Issuance New $15.00 222842155 Registration - New Motor Vehicle Registration New $0.00 Subtotal: $30.00 Sales/Use Tax: $0.00 Credit Applied $0.00 Total: $30.00 Payment Method Amount Authorization Number Name CREDIT $30.00 045138 Total Due: $30.00 Amount Paid: $30.00 Change Due: $0.00 Within 10 business days,you will receive your registration or title through the United States mail. You will be able to track the progress of your registration or title by using your PIN number listed above when calling the BMV Customer Service Center at 888-myBMV-411 (888-692-6841). If you have questions or comments, please call our Customer Service Center at 888-myBMV-411. Please help us improve our service by completing a one-minute customer satisfaction survey. Your responses are completely confidential. Visit http:ywvAv.in,(iov/brnvsurveu/start and enter the survey code 185719396 to get started. Thank you. Page 1 of 1 II ill/)Ili 11111 I I I III II IIII I I I I l l II II I Ill/l II III II I II I 6 1 7 1 7 2 2 2 8 4 2 1 5 5 State Form 48099(R2/11-10) '• {' Approved by State Board of INDIANA CERTIFICATE OF VEHICLE REGISTRATION �.. Accounts 2010 CLASS I AGE ISSUE DATE PUR DATE COUNTY TP I PL YR PLATE PL TP WEIGHT PR YR LS I TYPE 06/1912013 05/3112013 29-HAMILTON N 2012 MO N EXPIRATION DATE PRIOR PLATE VEHICLE YEAR MAKE TYPE MODEL COLOR VEHICLE IDENTIFICATION NUMBER NO EXP 2013 FOR TK F1S WHI/ 1 FTFW1 ET8DFC36416 CURRENT EX TAX EX CREDIT DAV CREDIT EX TAX DUE WHEELISUR STATE REG FEE ADMIN FEE TOTAL DUE YEAR TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0100 PRIOR EX TAX EX CREDIT DAV CREDIT EX TAX DUq WHEEUSUR STATE REG FEE ADMIN FEE TOTAL DUE YEAR TAX 0.00 0.00 0.00 0.00 1 0.00 0.00 0.00 0.00 CITY OF CARMEL N 2 CIVIC SQ LB CARMEL,IN 460322584 IMPORTANT: REGISTRATION MUST BE SIGNED TO BE VALID swear or affirm under penalty of perjury that the information contained in this form is correct. I swear or affirm that proof of financial responsibility (insurance) for this vehicle will be continuously maintained during the registration period. I understand that the vehicle's registration is not valid until the Bureau receives the total amount owed. Additional taxes and/or fees may be due if an error or an adjustment to the amount due is made. Vehicle Registrant Signature(s) (All vehicle registrants must sign in ink to be valid) X CUSTOMER COPY c� State Form 48099(R2/11-10) �.,_..� Approved by State Board of INDIANA CERTIFICATE OF VEHICLE REGISTRATION counts CLASS I AGE JISSUE DATE I PUR DATE COUNTY TP PL YR PLATE PL TP WEIGHT PR YR LS TYPE 06/19/2013 05/31/2013 29-HAMILTON N 2012 MO IN EXPIRATION DATE PRIOR PLATE VEHICLE YEAR MAKE TYPE MODEL COLOR VEHICLE IDENTIFICATION NUMBER NO EXP 2013 1 FOR TK F1S WHIZ 1FTFW1ET6DFC36415 CURRENT EX TAX EX CREDIT DAV CREDIT EX TAX DUE WHEEUSUR STATE REG FEE ADMIN FEE TOTAL DUE YEAR TAX 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 PRIOR EX TAX EX CREDIT DAV CREDIT EX TAX DU WHEEUSUR STATE REG FEE ADMIN FEE TOTAL DUE YEAR TAX 0.00 0.00 0.00 0.00 0.00 0.00 0,00 0.00 CITY OF CARMEL N 2 CIVIC SQ LB CARMEL,IN 460322584 IMPORTANT: REGISTRATION MUST BE SIGNED TO BE VALID I swear or affirm under penalty of perjury that the information contained in this farm is correct. I swear or affirm that proof of financial responsibility (insurance)for this vehicle will be continuously maintained during the registration period. I understand that the vehicle's registration is not valid until the Bureau receives the total amount owed. Additional taxes and/or fees may be due if an error or an adjustment to the amount due is made. Vehicle Registrant Signature(s) (All vehicle registrants must sign in ink to be valid) X CUSTOMER COPY � IIII�IIIIIEI�I�Ilill�ll�l�ll�l lllllVllllIIIIB��I�I�IIIIIII� Bureau of Motor Vehicles Customer Detailed Transaction Receipt :8 r II,R State Form 51714 (4-04) Branch: VEHICLE SERVICES- REGISTRATIONS Date: 06/19/2013 Time: 11:08 EDT �1 Visit ID: 419396 CSR: LB Visit Customer: CITY OF CARMEL Transactions Trans IDTrans Type Trans Subtype Amount 222840598 Title- initial Title Issuance New Title Fee-Vehicle $15.00 Vehicle: 1 FTFW1 ET8DFC36416 2013 FOR F1 S CW Lien Holder: None Customer: CITY OF CARMEL Purchase Date: 05/31/2013 222841686 Title- Initial Title Issuance New Title Fee-Vehicle $15.00 Vehicle: 1 FTFW1 ET6DFC36415 2013 FOR F1 S CW Lien Holder: None Customer: CITY OF CARMEL Purchase Date: 05/31/2013 $30.00 Charges to your credit card will appear as a line item charge not as a total transaction charge. Page 1 of 1 ' Bureau of Motor Vehicles ' ,., .. Customer Registration Fees Detailed Receipt i State Form 51718 (4-04) -R::,....At. Branch:VEHICLE SERVICES-REGISTRATIONS Date: 06/19/2013 Time: 10:51 EDT Visit ID: '185719396 Tran ID: 222841224 Visit Customer: CITY OF CARMEL STARS Trans#: 06191380300020 Transaction Type: New Motor Vehicle Registration Registration License Type: MUNICIPAL OWNED PlatelPermIIlRegistration Number: Vehicle Identification Number: 1 FTFW1 ET8DFC36416 Vehicle Year: 2013 Vehicle Make: FORD Vehicle Model: F150 SUPERCREW Registration Year Fee Type Subtotal Total 2013 Total for 2013: 2012 NONE (NONE)2012 $0.00 CITY OF CARMEL Total NONE(NONE) 2012: $0.00 Total for 2012: 0.00 Transaction Total: 0.00 Charges to your credit card will appear as a line item charge not as a total transaction charge. Page 1 of 1 Bureau of !Motor Vehicles Customer Registration Fees Detailed Receipt k State Form 51718 (4-04) Branch:VEHICLE SERVICES- REGISTRATIONS Date: 06/19/2013 Time: 10:51 EDT Visit ID: 019396 Tran ID: 222842155 Visit Customer: CITY OF CARMEL STARS Trans M. 06191380300021 Transaction Type: New Motor Vehicle Registration Registration License Type: MUNICIPAL OWNED PlatelPermitlRegistration Number: Vehicle Identification Number: 1FTFW1ET6DFC36415 Vehicle Year: 2013 Vehicle Make: FORD Vehicle Model: F150 SUPERCREW Registration Year Fee Type Subtotal Total 2013 Total for 2013: 2012 NONE (NONE) 2012 $0.00 CITY OF CARMEL Total NONE(NONE) 2012: $0.00 Total for 2012: 0.00 Transaction Total: 0.00 'Charges to your credit card will appear as a line item charge not as a total transaction charge. Page 1 of 1 APPLICATION FOR CERTIFICATE OF TITLE - STATE OF INDIANA - BUREAU OF MOTOR VEHICLES State Form 205(R7!604) Approved by Slato Board of Account 1997 TORE COMPLETEDBYA POLICE OFFICER,6MVOFFICIAL OR BMV CERTIFIED DEALER SiGNEE IMIE THE UNDERSIGNED SWEAR OR AFFIRM THAT THE INFORMA- FOR OUT OF STATE TITLES.I HEREBY CERTIFY THAT I PERSONALLY EXAMINED THE FOLLOWING TION ENTERED ON THIS FORM IS CORRECT. 11WE UNDERSTAND VEHICLE AND FIND THE IDENTIFICATION NUMBER TO BE AS FOLLOWS. THAT MAKING A FALSE STATEMENT ON THIS FORM MAY CONSTI- VEH CLE IDENTIFICATION UMBER TUTE THE CRIME OF PERJURY. FUTHERMORE,VWE AGREE TO { ( INDEMNIFY AND HOLD HARMLESS THE INDIANA BMV FROM ANY �_ LIABILITY ARISING FROM THIS TRANSACTION. R MAKE MODEL TYPE DATE X INSPECTOR'S PRINTED NAME&TITLE CITY DATE: The ian requires That you arpty for Certificate of Title Ntlhin lhidy-one days from the date of purchase of a INSPECTOR'S SIGNATURE e D 0 motorvehide.There is adelinquent reoof 67I.00 for failure lodoso Attach Cetifwaleof Tdleass(gnedbyseller.Orion- DEALER PLATE PLATE NO. domed Trues,liens must be released supporting dowments surrendered with this application cannot be returned to the 41 cant.State reefor app"for TNais$I6.00.'in a ccorda nco with Fe dotal Code 360. TITLE NUMBER BRANCH NO INVOICE NO BMV SE ONLY 1. 061913803001Q6 803 MV-GOVERNMENT-CERTIFICATE OF ORIGIN 'SOC.SEC.IFEDERAL I.O.NO APPLICANT'S NAME BMV USE ONLY D 2. CITY OF CARMEL 0 STREET ADDRESS CITY STATE ZIP CODE N 3.1 ONE CIVIC SQUARE CARMEL IN 46032 0 VEHICLE I.D.NUMBER_— VER YEAR VEH MAKE VER MODEL NO. VER TYPE ODOMETER ACTUAL T 4• 1FTFW1ET8DFC36416 2013 FOR F1S TK 10M T FORMER TITLE NUMBER PURCHASE DATE LIEN SPEED PICKUP MAIL DEALER N0. BMV USE ONLY Y P 5• C OF O 05/31/2013 5 No No Yes E FIRST LIEN'S NAME OR SPECIAL MAILING ADDRESS STREET ADDRESS 6• CITY OF CARMEL 1 CIVIC SQ N CITY STATE ZIP CODE BMV USE ONLY 7. CARMEL IN 46032-2584 T H SECOND LIEN'S NAME STREET ADDRESS I 8• S CITY STATE ZIP CODE LICENSE NUMBER LICEN-$E FORMS BMV USE ONLY A 9 YEA USED LB R E GROSS RETAIL&USE TAXAFFIDAVIT-IfWE HEREBY CERTIFY THAT SALES OR USE TAX ON THIS VEHICLE WAS PAID AS INDICATED BELOW A S LLI G P lC LESS TRADE-IN ! DISCOUNT MOUNT SU13JECT TO T T AX DEALER I BRANC=EXEMPT P[- Art�10 o.00 o,00 o.ao $ o.00 'Your Social Security number/Federal 10.number is being request ad by this agency under IC 4-1-8-1. Disclosure is mandatory and this document cannot be processed eithout it APPLICANT RESPONSIBLE FOR ACCURACY OF INFORMATION APPLICATION FOR CERTIFICATE OF TITLE - STATE OF INDIANA - BUREAU OF MOTOR VEHICLES 2 0 b 2 2 2 8 4 0 5 9 8 CUSTOMER COPY APPLICATION FOR CERTIFICATE OF TITLE - STATE OF INDIANA - BUREAU OF MOTOR VEHICLES State Form 205(R716-G4) Approved by State Board of Account 1997 TO BE COMPLETED BY A POLICE OFFICER,BMV OFFICIAL OR BMV CERTIFIED DEALER SIGNEE IlWE THE UNDERSIGNED SWEAR OR AFFIRM THAT THE INFORMA- FOR OUT OF STATE TITLES.I HEREBY CERTIFY THAT i PERSONALLY EXAMINED THE FOLLOWING TION ENTERED ON THIS FORM ISCORRECT, IIWE UNDERSTAND VEHICLE AND FIND THE IDENTIFICATION NUMBER TO BE AS FOLLOW& THAT MAKING A FALSE STATEMENT ON THIS FORM MAY CONSTI- VEHICL IDE TIFICAT ON UMBER TUTE THE CRIME OF PERJURY. FUTHERMORE,WVE AGREE TO f I INDEMNIFY AND HOLD HARMLESS THE INDIANA BMV FROM ANY _ 1 LIABILITY ARISING FROM THIS TRANSACTION. R MAKE MODEL TYPE DATE X X INSPECTOR'S PRINTED NA vi E&TITLE CITY DATE: -DG�B RANCH�R•— The IaH requires That you apply for Ce(brcate oN Tnte w4Nrj tfuny�one days from the date of purchase of a INSPECTOR'S SIGNATURE motorvehkle.There is a delinquent fee of$21.00forfa0uretodoso.All ach Certificate of Tate assigned by serer.On en DEALER PLATE NO. domed TNes,rens must be released Suppoding documents surrendered with this eppr"Uon cannot be returned to Ne appre cans State fee for aped g for Tdle Is316.00.4n accordance pith Federal Code 363. TITLE NUMBER 8RANCH NO INVOICE NO BMV USE ONLY 1. 06191380300151 803 MV-GOVERNMENT-CERTIFICATE OF ORIGIN 'SOC.SEC./FEDERAL I.D.NO APPLICANTS NAME BMV USE ONLY D 2. CITY OF CARMEL 0 STREET ADDRESS CITY ISTATE ZIP CODE N 3. ONE CIVIC SQUARE CARMEL JIN 46032 0 VEHICLE I.O.NUMBER VEK YEAR VE}{MAKE VEFi MODEL NO. VEH.TYPE ODOMETER T ACTUAL 4• 1FTFW1ETWFC36415 2013 FOR F1S TK 10 M T F RM ffT ITLE NUMBER P RC ASE DATE LIEN SPEED PICKUP MAIL DEALER NO. BMV SE ONLY Y P 5. C OF O 05131/2013 5 I—No No Yes E FIRST LIEN'S NAME OR SPECIAL MAILING ADDRESS STREET ADDRESS I 6. CITY OF CARMEL 1 CIVIC SQ N CITY- STATE ZIP CODE BMV USE ONLY 7. CARMEL IN 46032-2584 T _ H SECOND LIEN'S NAME STREET ADDRESS 1 8 S CITY STATE ZIP CODE LICENS NUMBER LICENE FORMS BMV USE ONLY A 9. Y� USED LB R GROSS RETAIL&USE TAX AFFIDAVIT•IANE HEREBY CERTIFY THAT SALES OR USE TAX ON THIS VEHICLE WAS PAID AS INDICATED BELOW A SELLI G PR ' LESS TRADE-IN ISC NT M BJEC g T DEAL R BRANCH E 10- $ 0.00 $ O.00 o.00 o.oa x i Your Social Security numberl Federal l D.number is being requested by this agency under I134-11$-1. Disclosure Is mandatory and this document cannot be processed%i9*ut it APPLICANT RESPONSIBLE FOR ACCURACY OF INFORMATION APPLICATION FOR CERTIFICATE OF TITLE - STATE OF INDIANA - BUREAU OF MOTOR VEHICLES III I�IICIIIIIrII�lIIIlfil�ll�llll�l-Cllr 2 0 5 2 2 2 8 4 1 6 8 6 CUSTOMER COPY 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)) New F1 50's $30.00 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 Gary Carter IN SUM OF $ $30.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 I I 43-583.00 I $30.00 1 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 JUL -7 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund