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.:Print Form Village of Wappingers Falls 2628 South Ave WAPPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER & VOUCHER Department: CLAIMANT'S Jessica Fulton NAMEAND 69 Ketchamtown Road ADDRESS Wappingers Falls, NY 12590 Due on Receipt TERMS Purchase Order No. DO NOT INR/TE /N TH/S BOX Data Voucher Received FUND -APPROPRIATION AMOUNT TOTAL ~ ~® OO ABSTRACT NO. VENDOR'S REFNO. DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT 1o Reimbursement for Vital Statistics Fees S1 .oo Ipo Death Certificates - 10 Copies m ~~ ~ ~~ TOTAL $1 00.0 certify that the above account in the amourn of $ 100.00 is true and correct; that the items, services, and disbursements charged were rendered to or for the murricipaliry on the dales stated; that no pert has been paid or satisfied; that taxes, from which the municipality is exempted, a not included: and that the amount Gaimed is actually due Town CIerWRegistrar DATE SIGNATURE TITLE (SPACE. BELOW FOR MUNICIPAL DEPARTMENT APPROVAL The above services or materials were rendered or furnished to the municipality on the dates stated and the charges are correct APPROVAL FOR PAYMENT This Gaim is approved paid from the appropriations indicated above AUTHORIZED OFFICIAL DATE DATE COMPTROLLER ~ O O~ ~ ~ ~ 1 ~ O W ~, v _ O ~ ~ 2 / ~ D ~' ., n i T 'D ~ Z ~ ~, O tom 0 IL N 0 ~ <g~~- r NZ~ Lfl _A~A C ~ w 0 Z W C ^ s ~ 7 , ~ ~ ' rH D ti r rl.! 2 0 N r Z ~ :. n i 3 n i '~ f. O ~ % O E o Q p A ~j ~JJ ~ n> o a , ~ ~ ~ w D m 1 ' _ t V ~ f O p N ~ (D ~ SeauityteeWres..Deteils on beck. ~ '. Prir~t,lrorm Village of Wappingers Falls 2628 South Ave WAPPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER & VOUCHER Department: cuIMANT•s Jessica Fulton NAMEAND 69 Ketchamtown Rd ADDRESS Wappingers Falls, NY 12590 Purchase Order No. DO NOT WR/TE IN THIS BOX Date Voucher Received FUND -APPROPRIATION AMOUNT TOTAL $ Q ABSTRACT NO. Due on Receipt TERMS VENDOR'S REFNO. DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT 9 Reimbursement for Vital Statistics Fees $i .oo Death Certificates - _9_Copies `~` v~ TOTAL $ 90.0 Jessica Fulton 90.00 tartly t above account in the amount of S is true and correct; that the items, services, and disbun;emerns charged were rendered to or for the munidpality dat ;that no part has been paid or satisfied; that taxes, from which the munidpeliry is exempted, are not induded: and that the amourn daimed is a ally due 05/29/2012 Town CIerWRegistrar DATE SIGNA RE TITLE (SPACE BELOW FOR MUNICIPAL USE) DEPARTMENT APPROVAL The above services or mater'ia~-were r~e~ or furnished to the municipality on the dates stated and the charges are correct APPROVAL FOR PAYMENT Tots claim is approved paid from the appropriations indicated above DATE AUTHORIZED OFFICIAL DATE COMPTROLLER -~ o' ~~ O O ~. r 0 RJ ti 0 o '~ 0 0 r m` .: w IL Ll'1 U~ ti ~a o~ Z o0 ~~ o = ~ I rn n~ a. o < o = m .f ..~ 0 -„ -n v N N -~ c t'1 a ~ a O C Z rn a r 0 m r. -o ~ =z ~ Z ,..rn~m Q ~~~.~ a~ ~~~ ~~x~.a ~cnjm C o~ ~~ N ~~ o Q~Qpp A 'L' j N ^77 ~ 4 i r ~. ~ ~ ~ ~ GO O ~ * * ~ ~ O N _-- __ . O ~ a ~ a ~ ~~. ~ ~ ~rint....~.~. Village of Wappingers Falls 2628 South Ave WAPPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER & VOUCHER Department: CLAIMANT'S Jessica Fulton NAMEAND gg Ketchamtown Road ADDRESS Wappingers Falls, NY 12590 Due on Receipt TERMS Purchase Order No. DO NOT WRITE /N THIS BOX Date Voucher Received FUND-APPROPRIATION AMOUNT TOTAL $O OO ABSTRACT NO. VENDOR'S REFNO. 7 Quantity DESCRIPTION OF MATERIALS OR SERVICES 2.00 Reimbursement for Vital Statistics Fees Death Certificates - 2 Copies Jessica Fulton 20.00 certify that the above account in the amount of $ is true and correct; that the items, services, and disbursements charged were rendered to or for the municipality on th ales statetl; that no pert has been paid or satisfied; that taxes, from which the municpaliy is exempted, are not inGuded: and that the amount Gaimed is actually due 10/22/2012 / Deputy Town Clerk DATE SIGNATURE TITLE (SPACE BELOW FOR MUNICIPAL USE) DEPARTMENT APPROVAL The above services or materials were rendered or furnished to the municipality on the dates stated and the charges are correct APPROVAL FOR PAYMENT This Gaim is approved paid from the appropriations indicated above DATE AUTHORIZED OFFICIAL DATE COMPTROLLER ~" `~ t~Form Village of Wappingers Falls 2628 South Ave WAPPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER & VOUCHER Department: CLAIMANT'S Jessica Fulton NAMEAND 69 Ketchamtown Road ADDRESS Wappingers Falls, NY 12590 Purchase Order No. DO NOT WRITE IN THlS BOX Date Voucher Received FUND -APPROPRIATION AMOUN T TOTAL $O OO ABSTRACT NO. ..~~~~..u ~ ..~.~~ ~ 40.00 certify that the above account In the amount of $ is We and correct; that the items, services, and disbursements charged were rendered to or for the municipeltty o e tlates stated; that no pert has been paid or satisfied; that taxes, from which the municipality is exempted, are not included: and that the amount Geimed is a wally due c 03/19/2013 Deputy Town Clerk/Registrar DATE SIGNATURE TITLE BELOW FOR MUNICIPAL USE) DEPARTMENT APPROVAL The above services or materials were rendered or furnished to the municipality on the dates stated and the charges are correct DATE AUTHORIZED OFFICIAL APPROVAL FOR PAYMENT This claim is approved paid from the appropriations indicated above DATE COMPTROLLER TERMS DUe On ReCelpt VENDOR'S REFNO. I rlelx'ane4~, ~uzei~rcl,~(nnze- I East Main Street ~ P.Q. Box 185. Wappingers Falls, NY 12590 ~~~~!'lt li; (- t t CI11 1[(41 __ Srr iiw ( /rrii,-(ib ~,m ~crnir irr~-~:; r~J~. ,.,.-..____. 1537 50-7044/2223 PAY DATE --~~ a.~ l 9 .20 ~ ~ sus TO THE ORDER OF ~ ~~ DOLLARS 8 s••~„„ \\ F1RST ~ F••~•~•• `l\ B•c4 • on NIAGARA FOR ~ - ~r1 ~-dC - y~~~t~ ~ ` ~~'00 i 5 3 7u^ i• ~ ~ _ . 2 2 2 3 70 4 40.00008 2 70 2 5 1 2n^ ~ ~~~ Print Form i Village of Wappingers Falls 2628 South Ave WAPPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER & VOUCHER Department: ctaIMANT•s Jessica Fulton NAMEAND 69 Ketchamtown Road ADDRESS Wappingers Falls, NY 12590 TERMS Due on Receipt Purchase Order No. DO NOT WRITE /N THIS BOX Date Voucher Received FUND -APPROPRIATION AMOUNT TOTAL $O OO ABSTRACT NO. VENDOR'S REFNO. certify that the above account in the amount of $ 60'0 is true and correct; that the items, services, and disbursements charged were rendered to or for the munic li on t dates stated; that no part has been paid or satisfied; that taxes, from which the municipality is exempted, are not included: and that the amount claimed is actually due 04/30/2013 -- Deputy TownClerWRegistrar DATE SIGNATURE TITLE (SPACE BELOW FOR MUNICIPAL l IRI=1 DEPARTMENT APPROVAL The above services or materials were rendered or furnished to the municipality on the dates stated and the charges are correct DATE AUTHORIZED OFFICIAL APPROVAL FOR PAYMENT This claim is approved paid from the appropriations indicated above DATE COMPTROLLER ~a ~_ _ ~~ N c ~_ c M ~ ~' s .~ ~ ~ ~ ~ ~ ~ L ~ C\ O V Q M y ~~ ~ n V M ._ ~ Q. ~ 1 J ~ ~ ~~ ~ O rv O ._. M 1 tY1 .a W j - ~, O A ~~ ti i n ~ / _, , Q ~ ~ s WAN Z Y r `~ = r1'I ~ ~ z s r. ~gz ~ W ~+ = g' ?~ ~ ~ g O ~ o~ ~ aLL~~ O Zzm mow° ~_ W w O ~w ~ > -. ~ °Z rz ~? c~ ¢m~= c~ W ~, > ¢~ Z H ~`` t ~ Sm _ _ ~~ WZ >, ~ ? . ~ ~, ~~ ~ ~ a O Print Form ~` Village of Wappingers Falls 2628 South Ave WAPPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER & VOUCHER Department: CLAIMANTS Jessica Fulton NAMEAND 69 Ketchamtown Rd ADDRESS Wappingers Falls, NY 12590 Purchase Order No. DO NOT WRITE /N THlS BOX Date Voucher Received FUND -APPROPRIATION AMOUNT TOTAL $O 00 ABSTRACT NO. Jessica Fulton 100.00 certiry that the above account in the amount of $ is true and correct; that the items, services, and disbursements charged were rendered to or for the municipality a dates staled; that no part has been paid or satisfied; that taxes, from which the municipality is exempted, are not inGuded: and that the amount claimed is actually due r 04/10/2013 Town Clerk/Registrar DATE 51GNATU E TITLE (SPACE BELOW FOR MUNICIPAL USE) DEPARTMENT APPROVAL The above services or materials were rendered or furnished to the municipality on the dates stated and the charges are correct DATE AUTHORIZED OFFICIAL APPROVAL FOR PAYMENT This claim is approved paid from the appropriations indicated above DATE COMPTROLLER Due on Receipt VENDOR'S TERMS REFNO. O r 0 m Q'7 -.~ ^e O ti 0 0 0 0 r m .: .n w l.ll ti U'1 .~ Il.l n 0 v m' .~ w ~' m O n~ cQ m 0 v v_ ~' cQ (D N T a m 0 N L7 9 m ~a ~O o -+ I" m rs~ ~F rt * * * ~, ~ O * O Y (~ v 0 r Security features. Detetls on back. -N~i a C W `g ~ C Z m n r 0 m a r ~z ~ Z =mom O ~'°°~~ V ~,. aOZ = t~rXy Ny,; r ~ m< o ~ ~ R1 ro < n D ~~ a~ A O e r O Print Form . ;~ Village of Wappingers Falls 2628 South Ave WAPPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER & VOUCHER Department: culMArms Jessica Fulton NAMEAND 69 Ketchamtown Road ADDRESS Wappingers Falls, NY 12590 Due on Receipt VENDOR'S TERMS REFNO. DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT 05/02/2013 4.00 $1 .00 Reimbursement for Vital Statistics Fees Death Certificates - 4 Copies- Letizia TOTAL $4 0.0 Jessica Fulton 40.00 certify t the above account in the amount of S is true and correct; that the items, services, and disbursements charged were rendered to or for the municipality th dates state ;that no part has been paid or satisfied; that taxes, from which the municipality is exempted, are not includetl: and that the amount Gaimed is actually due 05/02/2013 Deputy Town Clerk/Registrar DATE SIGN E TITLE (SPACE BELOW FOR MUNICIPAL USE) DEPARTMENT APPROVAL The above services or materials were rendered or furnished to the municipality on the dates stated and the charges are correct Purchase Order No. DO NOT WR/TE /N THIS BOX Date Voucher Received FUND-APPROPRIATION AMOUNT TOTAL $O OO ABSTRACT NO. APPROVAL FOR PAYMENT This claim is approved paid from the appropriations indicated above AUTHORIZED OFFICIAL DATE DATE COMPTROLLER . -~- 1 E i O Q~ ~ r ny ~" -, a c ,~ ^^ _: RI f11 IL W ~] <~ 1- ', I r 0 K~ p ~ ^ ^ ~l ~~~ ~~ I° ti ~~ r ~ n., L -. o-~~ o~D o O ~' ~' m=-< ~m ~ ~ m ~ o ~. 7' k A ~ T ~ r H ~ O C T ~ ~ ~ y ~, ~ Z ~ N ~ (ti O C~ 0 D m 9~ ~ o r r Q D ~ 4 ~ 6 ~oT_ T i '~. ~M1 I ~' ~. ~:. o ~ o A O ~ ~ ~- ^ ~.:.. ' .. ?i•int Form ~~ r Village of Wappingers Falls Order No. 2628 South Ave WAPPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER & VOUCHER Department: cu~IMANrs Jessica Fulton NAMEAND 69 Ketchamtown Road ADDRESS Wappingers Falls, NY 12590 TERMS DUe On ReCelpt DO NOT WR/TE IN THIS BOX Dale Voucher Received FUND-APPROPRIATION AMOUN T TOTAL $O OO ABSTRACT N0. VENDOR'S REFNO. DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT 07/23/2013 4 Reimbursement for Vital Statistics Fees $1 .oo Death Certificates - 4 Copies Wheeler TOTAL $ 40.0 Jessica Fulton cart' that the above account in the amount of $ 40.00 is true antl correct; that the items, services, end disbursements charged were rendered to or for the municipal' o the d es stated; that na pert has been paid or satisfied; that taxes, from which the municipality is exempted, are not included: and that the amount Gaimed is actually due r 07/23/2013 Deputy Town CIerWRegistrar DATE SIGNATURE TITLE (SPACE BELOW FOR MUNICIPAL USE) DEPARTMENT APPROVAL The above services or materials were rendered or furnished to the municipality on the dates stated and the charges are correct APPROVAL FOR PAYMENT This claim is approved paid from the appropriations indicated above DATE AUTHORIZED OFFICIAL DATE COMPTROLLER 0 0 N N r ~ N ~ N r r. r O 0 ~~! of m • 0 Q Z C . ~ . m A ~ ~ °O `. Q a ~ O ~ S o O C Z 0 _ CI ~ ~~ ~ i U `~ _ ~ c v m ~ W 'I ~v~o ~ o Q w v U W 0 0 0 i~ • • ~ v~ W _I Q Ll CIS O ~ 07 ~~W~~{{ ~ Ll T /'~/~ } 4^. I..L 2~ W O ~ ~ 'W ~ p> V C~ G J_ (>~ ~ N fl- O O~ f- wo ~O 0 0 M N d s 0 E a~ a Print Eorm ., Village of Wappingers Falls 2628 South Ave WAPPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER & VOUCHER Department: CLAIMANT'S Jessica Fulton NAMEAND 69 Ketchamtown Road ADDRESS Wappingers Falls, NY 12590 Due on Receipt TERMS Purchase Order No. DO NOT WR/TE IN TH/S BOX Date Voucher Received FUND -APPROPRIATION AMOUN T rora>_ $0 00 ABSTRACT NO. VENDOR'S REFNO. DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT 3 Reimbursement for Vital Statistics Fees S1 .oo 08/30/2013 /~(,l~/~i~~'N ~ Deputy Town Clerk/Registrar DATE ~- SIGNATU TITLE (SPACE BELOW FOR MUNICIPAL USE) DEPARTMENT APPROVAL The above services or materials were rendered or furnished to the municipality on the dates stated and the charges are correct APPROVAL FOR PAYMENT This claim is approved paid from the appropriations indicated above DATE AUTHORIZED OFFICIAL DATE COMPTROLLER Jessica Fulton 30.00 certify that the above account in the amount of 5 is true and cortecr that the items, services, and disbursements charged were rendered to or for the mygicipality on the dates stated; that no pert has been paid or satisfied; that taxes, from which the municipality is exempted, are not included: and that the amount claimed is actualN dyQ n ~~ ' .~ a ~; O a r- ~~I I~`I I ~, '~I i =: I ;'~~i i I ~. ~~ 1 Fi°I ~. +=~ i~I i~~ .~ ~~I i:: ~_. ~m~ ;~~ ~: ~''° ~ Iii ~_ -~ ,V ~. ,,~ ~LLO~ ~p ~ V J \ (`'(~ ~ H 0 ~ ~ N N Z ~ ~= ~ o ~ ~~~~ O ,~ N LL G ~ ~'_ o.~ ~ O W ¢ C p cp Q 'v O r ~ W ~ ~ d ¢ I`04 ~ O 9 ~y 1 F~ V ~a ~Z • f RJ Ti .-i aI~ 1'LI I i ~ i r'{.I ^_^ 1 S O o- ru ru ru :' ._ O r. .-a O ~ O _ ~ 0 LL Prir~,Form Village of Wappingers Falls Purchata Order No. 2628 South Ave WAPPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER & VOUCHER Department: cvtMANrs Jessica Fulton NAMEAND 69 Ketchamtown Raad ADDRESS Wappingers Falls, NY 12590 Due on Receipt VENDOR'S TERMS REFNO. DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT 08/20/2013 5.00 $1C .00 Reimbursement for Vital Statistics Fees Death Certificates - 5 Copies Burns TOTAL $ 50.0 Jessica Fulton is true and correct; that the items, services, and disbursements charged were rendered to or for the muniupelity is exempted, are not inGUded: and that the amount claimed is actually due 08/20/2013 DATE (SPACE BELOW FOR MUNICIPAL Town CIerWRegistrar TITLE DEPARTMENT APPROVAL The above services or materials were rendered or furnished to the municipality on the dates stated and the charges are correct DO NOT WRITE IN THIS BOX Date Voucher Receivatl FUND -APPROPRIATION AMOUNT TOTAL $O 00 ABSTRACT NO. ty that the above account in the amount of $ 5Cf'00 on tFjetdates stated; that no part has been paid or satisfied; that taxes, from which the ~~~~~ APPROVAL FOR PAYMENT This claim is approved paid from the appropriations indicated above AUTHORIZED OFFICIAL DATE DATE COMPTROLLER +~ ^iiti~~S~bOLti :~~dt00f220:~ .Ii9ZZt00.l1 ----------- 3tifI1VNJI5O3Zltl d' ~ ~'~p/~.~y'y~"'7 ~-~ ~ Q~/1~3W.. 7~` m m n c ,7 satn~oa Q m c o p p ' 9 S ~ '~ 'p ~i~ ~o a3aao ~ , 3H1 Ol ,lt/d 0 ~o l ~+ ~ b£Z6-TZZ-Sb8 ££SZT ,lN 'NOLLONfIf 113M3dOH 'Z8 1a 006 £ZZ'Li'OS 99i9-968-Sb8 bZSZi AN IIINHSId ''1S NIVW 8ZOT w°~~~y~•"""""" '~NI `3WOH lt/li3Nf1~ JIdOOWH~fI~d 'H 1»390a ,oi ~ .V'N '~ueg asey~ ue6~oWdf ~j 35bH~ Print Ford .~ Village of Wappingers Falls 2628 South Ave WAPPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER & VOUCHER Department: CLAIMANTS Jessica Fulton NAMEAND 69 Ketchamtown Road ADDRESS Wappingers Falls, NY 12590 Due on Receipt TERMS Purchase Order No. DO NOT WR/TE /N THIS BOX Dete Voucher Received FUND-APPROPRIATION AMOUNT TOTAL $O 00 ABSTRACT N0. VENDOR'S REFNO. DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT 2 Reimbursement for Vital Statistics Fees Si .oo Death Certificates - 2 Copies Bairan TOTAL $ 20.0 Jessica Fulton celiiry 1 is true and correct; that the items, services, and disbursements charged ware rendered to or for the municipality on municipality is exempted, are not included: and that the amount claimed is actually due , 09/04/2013 DATE Deputy Town CIerWRegistrar TITLE DEPARTMENT APPROVAL The above services or materials were rendered or furnished to the municipality on the dates stated and the charges are correct APPROVAL FOR PAYMENT This claim is approved paid from the appropriations indicated above DATE AUTHORIZED OFFICIAL DATE in the amount of s 20.00 no part has been paid or satisfied; that taxes, from which the COMPTROLLER (SPACE BELOW FOR MUNICIPAL USE) ~_ ~ ~ r~ ~Hoeq uo sl!elap ~sam3ea; punoeg w ~ ~ lA Q J i `~ M ~ ~ O N ~ ~ N * ~ ~ ~ ~' r z ~ ~ ~ o t w N ~ ~ # ~ # * _ j i~ A Q J N it it ~ ~ ~ ~ Li 0.~. Z.N {~ ~~C7W~ W Cn Z'd _ Z rmYO *~ Ovrn=irl ,~ 0 C7 ` ""' O, _ o. ~ x w rr^^ ,* v1 ~ ~ O x (A ~ 0 = 00 m (0 ~ r-~ JV aN N N (O [~ s QZ ° ~ ~ * ~ LL ¢ _-~1 ~ ~~ ~ .~ ~ W o Z Q. ~ ~ ~ o_ ~' Q N ~ C . _ Z Q /w] ma ~ ~ ~ Q ~ ~I j LL : QO O O ~i > }p~ K m= ~ ~ ~ r~ O O N ~ ~ '~ ~ C ~ .> W LL ~ ~ o C W 3 Q ° i- ao C fL .~ m U. C .` V. C O W ^_ 1'11 1 IL 1'LI a O O O O :' c0 r~ Q' N .-. ti ti .' L1l C~ .i Print Form ..... r Village of Wappingers Falls 2628 South Ave WAPPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER & VOUCHER Department: CLAIMANTS Jessica Fulton NAMEAND 69 Ketchamtown Road ADDRESS Wappingers Falls, NY 12590 TERMS DUe On Receipt Purchase Order No. DO NOT WRITE /N TH/S BOX Dete Voucher Receivetl FUND -APPROPRIATION AMOUNT roraL $0 00 ABSTRACT NO. VENDOR'S REFNO. DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT 9/24/2013 4 Reimbursement for Vital Statistics Fees $1 .oo Death Certificates - 4 Copies TOTAL $ 40.0 Jessica Fulton 40.00 certify that the above account in the amount of $ is true and cortect; that the items, services, and disbursements charged were rendered to or for the municipality o e dates stat d; that no part has been paid or satisfied; that taxes, from which the municipality is exempted, are not inclutletl: and that the amount claimed is actually due c 09/23/2013 ~>~~'~~ Town Clerk/Registrar DATE SIGNATURE TITLE (SPACE BELOW FOR MUNICIPAL USE) DEPARTMENT APPROVAL APPROVAL FOR PAYMENT The above services or materials were rendered or This claim is approved paid from the appropriations indicated above furnished to the municipality on the dates stated and the charges are correct DATE AUTHORIZED OFFICIAL DATE COMPTROLLER • 0 r r r ti w ^ ^ ti ti 0 0 0 0 r m :. .a w Lfl ~7.J .0 .0 r1J v m -n m 0 o -~ v~ N 0 70 0 ~ ~ o= „ n C sy m ~ < o- C1 °o < ~ r 0 0 ~ ~ a ~ ~, - ~ =Z ~ z m om ~ a ~ ~ v : ~so~ Re N• ~ * ~ rocky su ~' m ~ o ~ ~ m ~ ~ ~, ~ N s ~ rt ~ ~ ~ C m a r o m r ,~ * ~~ ~~ Qp * A 3 * * * N c ^J N c O t s rt s x~ +*F * ~ ~ ~ o CD ~ N r * * ~ ~ W N O W O r r Secur ity textures. Details on back. N Z~ D m F n G ' F'rint norm Village of Wappingers Falls 2628 South Ave WAPPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER & VOUCHER Department: CLAIMANTS Jessica Fulton NAMEAND gg Ketchamtown Road ADDRESS Wappingers Falls, NY 12590 Due on Receipt TERMS Purchase Order No. DO NOT WR/TE /N THIS BOX Date Voucher Received FUND -APPROPRIATION AMOUNT TOTAL $O 00 ABSTRACT NO. VENDOR'S REFNO. DATES INV# Quantity .DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT 11 /25/2013 2.00 $1 .00 Reimbursement for Vital Statistics Fees Death Certificates - 2 Copies TOTAL $ 20.0 Jessica Fulton 20.00 certify that the above account in the amount of $ is true and cortect; that the items, services, and disbursements charged were rendered to or for the municipality on th tes stet ,hat o part has been paid or satisfied; that taxes, from which the municipality is exempted, are not included: and that the amount claimed is actually due 11/25/2013 Town CIerWRegistrar DATE SIGNATURE TITLE (SPACE BELOW FOR MUNICIPAL USE) DEPARTMENT APPROVAL The above services or materials were rendered or furnished to the municipality on the dates stated and the charges are correct DATE AUTHORIZED OFFICIAL APPROVAL FOR PAYMENT This claim is approved paid from the appropriations indicated above DATE COMPTROLLER _ ~- _= i1 1; 21 ~ p ~ a 0 A ~' ~~~ /// y ~. .11 O ~ ~ ~ k ~ f (., ~~ ( D .v h ~ ~ ~~ I~. ~ ~ ~~ _ T ~ _ ~ n ~ ,~y ~; _ ny r ; ^ Y 1 ~ ~ ~ n ~ ~ ~ N U ~ ~ ~~ ~ i~ O ~~ -~] ;~ ~ , ' ~ '~ ~ ~, PLI ~ ~ !~ 3_ 1'L ? f , W O ~' ~r 'o ' •~ o , = ~~ o ~; o =- ~ ~ _i L1'I Dp " r -I m ru N ~ ~; '; ~ 6 - ~ {f} G O r ~ W ~~; f~ r Ci it:- D ~ . F l J S: G A ~a ~, 't ~~ I ~_ ~a ~_ U W ~ ~ I~~ 1 k. P.rirtt Forr DO NOT WRITE IN TH/S BOX Date Voucher Received FUND -APPROPRIATION AMOUN T TOTAL $O 00 ABSTRACT NO. Due on Receipt VENDOR'S TERMS REFNO. DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT 5 Reimbursement for Vital Statistics Fees $1 .oo Death Certificates - 5Copies Gordon TOTAL $ 50.0 Jessica Fulton 50.00 certify that the above account in the amount of 3 is true and wrrect; that the items, services, and disbursements charged were rendered to or for the munici on the dales stated; that no part has been paid or satisfied; that taxes, from which the municipality is exempted, re not Guded: and that the amount claimed is actually due l • -`~ Deputy Town CIerWRegistrar DATE SIGNA RE TITLE (SPACE BELOW FOR MUNICIPAL USE) DEPARTMENT APPROVAL The above services or materials were rendered or furnished to the municipality on the dates stated and the charges are correct APPROVAL FOR PAYMENT This claim is approved paid from the appropriations indicated above Village of Wappingers Falls 2628 South Ave WAPPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER & VOUCHER Department: cLAIMANT•s Jessica Fulton NAMEAND 69 Ketchamtown Road ADDRESS Wappingers Falls, NY 12590 Purchase Order No. DATE AUTHORIZED OFFICIAL DATE COMPTROLLER ~."". µt C7 0 ~~ :, _,~ :~o o , ~. r ~ r rL ~,-, ~'. •• Q Pl.l ~'. 0 o' o. o' r m'. :. .a w u~ rlJ lJl .~ fIJ 3 m 3 0 h v 0 v -a ~' ca fD 'n n~ ~D o~ ~o o -~ „m a C a ~Z Nz =m:om 0 ~y°~ sp ~~XZ = ~a JNw~p r "ar'Z~m o< ~ ~ N f~O O C z m ~~ a r O m ~~ ~r\ l 1J r O O O o ~ Q~p A (~ N a ^7 N s O N O W N Security features. Detells on back. ~ ~~ Print Form . -~ Village of Wappingers Falls 2628 South Ave WAPPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER & VOUCHER Department: CLAIMANT•6 Jessica Fulton NAMEAND 69 Ketchamtown Road ADDRESS Wappingers Falls, NY 12590 Due on Receipt TERMS Purchase Order No. DO NOT WRITE IN THIS BOX Date Voucher Received FUND -APPROPRIATION AMOUN T TOTAL $O OO ABSTRACT N0. VENDOR'S REFNO. DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT 1 Reimbursement for Vital Statistics Fees $1 .oo Death Certificates - 1 Copies TOTAL $ 10.0 Jessica Fulton 10.00 certify that the above account in the amount of $ is true and coned; that the items, services, and tlisbursements charged were rendered to or for the municipality on the dates stated; that no part has been paid or satisfied; that taxes, from which the municipality is exempted, are not included. and that the amount claimed is act ly ue 11 /06/2013 Deputy Town CIerWRegistrar DATE SIGNA TITLE (SPACE BELOW FOR MUNICIPAL USE) DEPARTMENT APPROVAL The above services or materials were rendered or furnished to the municipality on the dates stated and the charges are correct APPROVAL FOR PAYMENT This claim is approved paid from the appropriations indicated above DATE AUTHORIZED OFFICIAL DATE COMPTROLLER _` • 3 m 3 O o ~ : ~ - ~ ~c ~ cn ; r ~ ' ~ ~ _ ~ z O! c n °~ r ~ ~ -a r ~ ti r' N W 'rl N ~ ~ :^ O R.I ~ : 0 o ' 0 0 r m :. ' ~! w L!l rlJ Ul .~ Q~ RJ OD ~~ v -~ ~ O o= ~ m a 0 o ~ 0 T1 y n a c n v ~z ~ Z ?m:om O ~N~~a~ ~~X~a ~Z~m o~ N `S 11 C Z .m a r O m ~~ N s O x ,r * + % ,~ * ~ ~ Q O W O f Q N O v W 0 r Security features. Details on back. N W -r-m, Prinf Fol•m ~ "" , CLAIMANT'S NAMEAND ADDRESS Village of Wappingers Falls _2628 South Ave ~Wp,pPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER& VOUCHER rDepartment: Jessica Fulton 69 ~Ketchamtown Road :Wappingers Falls, NY 12590 TERMS Due on"Receipt DATES INV# ~ ~,, `u,,ntity .~~ 1 ~~~~ i~~ ~ ~,~~:~ ~` ~~ ' V ~t L~ Jessica Fulton ~ istrue:and'porTeot:'~~'?>~ municipality is exempted,;ere" .fit ll/06/201.3 ~.~;~ -:---- DAT,E ,, ,y... >, Purchase Order No. DO NOT WRITE IN THIS BOX Date Voucher Received FUND -APPROPRIATION AMOUNT TOTAL $O 00 ABSTRACT NO. VENDOR'S REFNO. DESCRIPTION OF MATERIALS OR SERVICES Reimbursement for Vital Statistics Fees Death_Certificates - 5 Copies UNIT PRICE AMOUNT $1 .oo TOTAL $50.0 .~;; 50.00 certify that the above account in the amount of $ .andJtlLvburtiementscharged were rendered to or for the municipality on the dates stated; that no part has been paid or satisfied; that taxes, from which the y~Cttha[ihe amountclaimed is actually due Deputy Town CIerWRegistrar ~" w. _ SIGNATURE TITLE (SPACE BELOW FOR MUNICIPAL USE) The above~ furnished 'to ~f .charges ~rec -,;; ,:, ~E?~1TAPPROVAL t 'm~rials were rendered or a7~~nn the dates stated and the AUTHORIZED OFFICIAL APPROVAL FOR PAYMENT This claim is approved paid from the appropriations indicated above DATE COMPTROLLER ~+. .:.. IDID~~" ~i'~` V ' ~ N m o~ ~ I /Y\ v \V~'\J / C_ ~ i ' ~ S Q ~ J i(; ~ J t j ^ V 7 ~ ; j . ~ Q . Ic ~ ~ ~., I Q ~ ;'~ ~ 44 f is i }~ _ ~ ~~ r ~ . R~ W ~ `~~ Q ~ 1"I.i '' J ~ O ~ i~ `` ~j j ~ ; y; _! I 'i ~ F. , ~ ~ /.~ W I ~!: W f O j o ~~ ~- o , o If .~ o ~~: s ~ ~ o ~ ~, ~„ I,__ ti ';vi ~=~ =' ~ - ;! ~, ~~ ' ' - ~- ;~` -_ a ~ c; h ~ ~ I E: ( ~ a ~ - ~~ ~ ~ Z ~~ ~Q ~ d N ~ ~ iry A a1~j 1L Z ~j c ~ N it C ~ K ~ O I` O m •~ ? a°o ~ Print Form ~~ Village of Wappingers Falls 2628 South Ave WAPPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER & VOUCHER Department: CLAIMANT'S Jessica Fulton NAMEAND 69 Ketchamtown Road ADDRESS Wappingers Falls, NY 12590 Due on Receipt TERMS Purchase Order No. DO NOT WR/TE IN THIS BOX Date Voucher Received FUND -APPROPRIATION AMOUNT TOTAL $O 00 ABSTRACT NO. VENDOR'S REFNO. DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT 10/30/2013 8.00 $1 .00 Reimbursement for Vital Statistics Fees Death Certificates - 8 Copies TOTAL $ g0.0 Jessica Fulton certify that the above account in the amount of $ 80.00 is true and correct; that the items, services, and tlisbursements charged were rentlered to or for them ' 'pality on the dates stated; that no part has been paid or satisfied; that taxes, from which the municipality is exempted, are not included: and that the amount claimed is actually due 11/01/2013 Town CIerWRegistrar DATE S NATURE TITLE (SPACE BELOW FOR MUNICIPAL USE) DEPARTMENT APPROVAL The above services or materials were rendered or furnished to the municipality on the dates stated and the charges are correct APPROVAL FOR PAYMENT This claim is approved paid from the appropriations indicated above DATE AUTHORIZED OFFICIAL DATE COMPTROLLER rn ~..~ M c-I U Z W 0 J Q ~ ~ 0 Z~r Z LJ., > Z Q Z ~ W ~OYd Ow ~w Q=Y a^" M ~ a W J J ~~ _~ N N O 0 ~ ~\~\ ,~.w` - V ~I ~~ W Q O O }Fw a°o m~ J J O '+~'+ AA/ ~i~f ~~ 1= 0 LL I r'I'1 ~I ~ \i J -~, O O O O N o- to .a O .... N Q' .~ ru ru J IY1 D Print Form ~.~ h Village of Wappingers Falls 2628 South Ave WAPPINGER FALLS, NY 12590 Telephone: (845) 297-8773 Fax (845) 298-2645 PURCHASE ORDER & VOUCHER Department: CIAIMANT•s Jessica Fulton "A"AeF'ND 69 Ketchamtown Road ADDRESS Wappingers Falls, NY 12590 Purchase Order No. DO NOT WRITE IN THIS BOX Date Voucher Received FUND -APPROPRIATION AMOUNT TOTAL $O OO ABSTRACT NO. Due on Receipt VENDOR'S TERMS REFNO. DATES INV# ;: ` Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT ; `;< ~ 4 Reimbursement for Vital Statistics Fees S~ .oo ~~~~.~~; . w ° ;, Death Certificates -4 Copies/ Mari ~:` ;,, f 4„ d':; ~ _, n~'- 4; ~. y:. . ri:: if . i.'i E~, ,W~., ~. ~' [:: '~ ~;'• ~,,, TOTAL $ 40.00 a'F u Iton 40.00 correct certify that the above account in the amount of $ that the items, services, antl disbursements charged were rendered to or for them ipality on the dates stated; that no part has been paid or satisfied; that taxes, from which the (-fs exempted, are not included: and that the amount claimed is actually due X13 ~ Town Clerk/Registrar DATE SIGNATURE TITLE `-~_ (SPACE BELOW FOR MUNICIPAL USE) DEPARTMENT APPROVAL ';above .services or materials were rendered or wed to the municipality on the dates stated and the s are correct APPROVAL FOR PAYMENT This claim is approved paid from the appropriations indicated above AUTHORIZED OFFICIAL ~ ~ DATE COMPTROLLER _~ 1 ~ •Hoeq uo s~islep `swniee; ,yun~eg ~ ~ Q ao g 0 o ~© ~p v ~ , ~ ~ ~~~ ~ W ~ e N ~. 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