HomeMy WebLinkAbout236722 09/08/14 �• CITY OF CARMEL, INDIANA VENDOR: 00350929
ONE CIVIC SQUARE INDIANA DEPT OF REVENUE CHECK AMOUNT: $*******176.75*
=a; CARMEL, INDIANA 46032 PO BOX 7229 CHECK NUMBER: 236722
INDIANAPOLIS IN 46207 CHECK DATE: 09/08/14
t tON
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 2 176.75 AUG 2014 2
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Xsisnat.
FAB-103 0812
Siga .
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I declarel}�nn penalties oCperjury that this is a true,correct and con return. a
Date lcJ ' Phone I I F Total Sales of Food&Beverages(Do Not Include Tax)
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(1%of Line C) D. b lV
AUG 2014 Collection Allowance(.73%of Line D)
0003120155 009 0 Due on or Before Do Not Use this Line if the Payment is Late E. I :3
SEP 30 2014 Net Tax Due(Subtract Line E from Line D) F. I .
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 2014Annual Interest Rate is3%
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 H)
INDIANA DEPARTMENT OF REVENUE
P•0- BOX 7229
INDIANAPOLIS, IN 46207-7229
I�InI�IIunI�IIIn1I11�lI�nInI�InI�II�InnI�Il�Iulln�l 08000011355495001025290001597083120]1401
XNe
Authd 4 , FAB-103 0812
I declare u er JenaI s ofperjury thatthis is a� complete m.
Date I Phone F Total Sales of Food&Beverages(Do Not Include Tax) A.
Total Exempt Food&Beverage Sales B.
CITY OF CARMEL BROOKSHIRE.GOLF COUR
Net Taxable Sales(Subtract Line B from Line A) C.
CARMEL UTILITIES
Taxpayer ID Number For Tax Period Tax Due(1%of Line C)
AUG 2014 Collection Allowance(.73%of Line D)
Do Not Use this Line if the Payment is Late
0003120155 004 0 Due on or Before
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 tiled late G,
❑Check if Amended-- Carmel-29291 *The 2014 Annual Interest Rale is 3%
Adjustments(An explanation must be attached) g,
I�II�I�IiI1�lllllri�I�lllr�lrllll11I1 Total Amount Due(Total Lines Fand Gplus orminus H)_ I. ! �j- '7S
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7229
INDIANAPOLIS, IN 46207-7229
I�I��LII�1��I�III1�1L1�ILI�L�I�I1�I111�I1�r�LII�L�1111�1 080000113554951010252929115970831201401
Prescribed by State Board of Accounts City Forth 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
V0 —4,9 -6 W_ Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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.
&ell� ALLOWED 20
IN SUM OF $
t �4-P15 (/\J L OW7
ON ACCOUNT OF APPROPRIATION FOR
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
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund