ABC County Auditor
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Installed in ABC County, 2022
Replaces County Form No. 17 (2020)
ACCOUNTS PAYABLE VOUCHER
ABC COUNTY INDIANA
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service is rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Vendor Name:
Vendor #
Address:
City:
State:
Zip:
Agent Name
Phone
1099 Eligible
False
True
EIN/SSN
Invoice Number
Invoice Dt
(mm-dd-yyyy)
Check Memo Description
Invoice Amount $
Add section
Fund#
1000 Community Transition Fund
1224 Reassessment
7120 Old Wireless 911
7402 MVH Distribution Fund
8820 93.788 Indiana State Opioid Response
Account#
Account Title
Amount
Remove
Total:
I 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
Submitting Dept.
Assessor
Auditor
Buildings & Grounds
Circuit Court
Commissioner
Community Corrections
Health
HR
IT
Sheriff
Superior Court 1
Superior Court 2
Superior Court 3
Weights & Measures
Email
Phone
Date of Submission
(mm-dd-yyyy)
Department Head Signature
Click here to sign
Date
(mm-dd-yyyy)
Title
I 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:
Commissioner Signature
Click here to sign
Date
(mm-dd-yyyy)
Title
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5-11-10-2.
County Auditor Signature
Click here to sign
Date
(mm-dd-yyyy)
Auditor Approved
No
Yes
Pay By Date
(mm-dd-yyyy)
Processed
No
Yes
Check No.
Check Date
(mm-dd-yyyy)
amount4
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