HomeMy WebLinkAbout236721 09/08/14 CITY OF CARMEL, INDIANA VENDOR: 00350929
.I; ® ,• ONE CIVIC SQUARE INDIANA DEPT OF REVENUE CHECK AMOUNT: $*******176.75*
9 ,?q CARMEL, INDIANA 46032 PO BOX 7229 CHECK NUMBER: 236721
ytTON INDIANAPOLIS IN 46207 CHECK DATE: 09/08/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 176.75 AUG 2014 1
XAuthorhV 4. a - FAB-103 0 812
siga to[
I declare rnQde penalties of perjury that this is a true,correct and corn return. Q /
Date /lC� I Phone �I� 6-7 1 Total Sales of Food&Beverages(Do Not Include Tax) A. I 0 O,�' tp q
Total Exempt Food&Beverage Sales B.
CITY OF CARMEL BROOKSHIRE GOLF COUR Net Taxable Sales(Subtract Line B from Line A) C. 9 '0 �q
CARMEL UTILITIES g
Taxpayer ID Number For Tax Period Tax Due(1%of Line C) D.
AUG 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. I `�
SEP 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 return is filed late G.'
❑Check if Amended , Hamilton-29000 *The 2014 Annual Interest Rate is 3%
III I I I III I I Adjustments(An explanation must be attached) H.
Total Amount Due(Total Lines F and'G plus or minus
INDIANA DEPARTMENT OF REVENUE
P-O- BOX 7229
INDIANAPOLIS, IN 46207-7229
08000011355495001,0252900015970831201401
XAut ori ed c ': FAB-103 0 812
sigI declare er ienal s dfperjury that this is a t q,correct an c-o7mnplleet M.
Date I Phone 5� I /� /�( F Total Sales of Food&Beverages(Do Not Include Tax) A.
�� J D
tJ Total Exempt Food&Beverage Sales B.
CITY OF CARMEL BROOKSHIRE.GOLF COUR /
Net Taxable Sales(Subtract Line B from Line A)
CARMEL UTILITIES
Taxpayer ID Number For Tax Period Tax Due(1%of Line C) D. O
AUG 2014 Collection Allowance(.73%of Line D)
0003120155 009 0 Due on or Before Do Not Use flus Line if the Payment is Late E,
SEP 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 ifretum is filed late G,
❑Check if Amended Carmel-29291 *The 2014 Annual Interest Rate is 3
Adjustments(An explanation must be attached)
L,IJJ�I���LII���L�IIt���II�L�II Total Amount Due
(Total Lines F and G plus or tninus H) �j-
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7229
INDIANAPOLIS, IN 46207-7229
LL�LII�r��I�IIIt�tL��II���L�I�I��I�II�L���l�ll�l��ll���l 080000113554951010252929115970831201401
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1
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
"o I Purchase Order No.
Terms
Date Due
Invoice Invoice Description•. Amount
Date Number (or note attached invoice(s) or bill(s))
V6_ .7
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 $
40
$
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
x(0.7 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
v
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund