230821 04/03/14 W Coq
a?,
*f� CITY OF CARMEL, INDIANA VENDOR: 00350929
® t _ ONE CIVIC SQUARE INDIANA DEPT OF REVENUE CHECK AMOUNT: $*""""'6.25*
?� CARMEL, INDIANA 46032 PO BOX 7229 CHECK NUMBER: 230821
INDIANAPOLIS IN 46207 CHECK DATE: 04/03114
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 GOLF 3/14 2 6.25 F & B TAX 3/14 2
FAB-1,03 0812
Authorized 'r -C
XSIgnaNre ,♦� ��J� - ,Q
I declare, der enalties of perjury that this is a true orre and complete m.
Date �j I Phone 2 Total Sales of Food&Beverages(Do Not Include Tax) A. LiI 71
Total Exempt Food&Beverage Sales B.
CITY OF-CARMEL BROOKSHIRE GOLF COUR � Z
CARMEL UTILITIES Net Taxable Sales(Subtract Line B from Line A) C. Z-q g
Taxpayer ID Number For Tax Period Tax Due(1%ofLine Q D.
MAR 2014 Collection Allowance(.73%of Line D)
0003120155 004 0 Due on or Before Do Not Use this Line if the Payment is Late E.
APR 30 2014 Net Tax Due(Subtract Line E from Line D) F.
Penalty is Greater of$5 or 10%of Line F(Plus Interest)* A
County/Town Use this line only if return is filed late G (L/
❑Check if Amended Hamilton-29000 *The 2014 Annual Interest Rale is 3%
Adjustments(.An explanation must be attached) g
I n 11 I l I�l u n I l I�i I I n n n 1 �I I Total Amount Due(Total Lines F and G plus or minus I-1)_ I. /n•7_
INDIANA DEE PARTMENTTOF REVENUE
P.O. BOX 7229
INDIANAPOLISn IN 46207-7229
Illlll�ll11�11�1111�111�11111�1��1�1111�11�1��1�i�ll�1�1111��1 08000011355495001,02529000159703312011403
Xs�mtzed a�l� �� FAB-103 0812
1 declare under enaltie,�o perjury that this is athis is a true, d co plete t
Date I Lf Phone 3I J t '��yt F Total Sales of Food&Beverages(Do Not Include Tax) A.
Total Exempt Food&Beverage Sales B.
CITY OF CARMEL BROOKSHIRE GOLF COUR
CARMEL UTILITIES Net Taxable Sales(Subtract Line B from Line A) C.
Taxpayer ID Number For Tax Period Tax Due(I%of Line C) D.
MAR 2014 Collection Allowance(.73%of Line D)
Do Not Use this Line if the Payment is Late Fi
0003120155 004 0 Due on or Before
APR 30 2014 Net Tax Due(Subtract Line E from Line D) F.
Penalty is Greater of$5 or 10%of Line F(Plus Interest)*
County/Town Use this line only if retum is filed late G. (f�
❑Check if Amended Carmel-29291 -The 2014 Annual Interest Rate is 3%
Adjustments(An explanation must be attached) g
Total Amount Due(Total Lines F and G plus or minus H) I.
INDIANN A DEPARTMENT OF REVENUE
P.0• BOX 7229
INDIANAPOLIS, IN 46207-7229
1�1�11,11111111111111111�11�1�il�l�ll�llllll����lllllll�llll�l 08000011355 4951010252929115970331201403
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(Rev.1995)
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
ue._Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Y G,Z�-
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
, 20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF $
N 6o
$
ON ACCOUNT OF APPROPRIATION FOR
Tjkv�d ko
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# 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
J/1
00
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund