221449 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
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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