HomeMy WebLinkAbout237710 10/02/14 CITY OF CARMEL, INDIANA VENDOR: 00350929
ONE CIVIC SQUARE INDIANA DEPT OF REVENUE CHECK AMOUNT: $*******145.68*
CARMEL, INDIANA 46032 PO BOX 7229 CHECK NUMBER: 237710
MUTON�. INDIANAPOLIS IN 46207 CHECK DATE: 10/02/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 145.68 F & B-GOLF 9/14
5
XAuthorizeA ( YA AB-103 0 812
Signature
1 declaree un r p aloes of perjury that this is a true,corre t and complete ret UF
Date I Phone � 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 Bfrom Line A) C. Cp
Taxpayer ID Number For Tax Period Tax Due(I%of Line C) D.
SEP 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.
OCT 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 Hamilton-29000 *The 2014 Annual Interest Rate is 3%
Adjustments(An explanation must be attached) H.
Initltl�ltnllrlltn��llitt�lltl��ll Total Amount Due(Total Lines Fand Gplus orminus H)_
INDIANA DEPARTMENT OF REVENUE l
P.O. BOX 7229
INDIANAPOLIS, IN 46207-7229
11113111IM]11111131In111111InlfIII III IIII11111111113111111 080000113554950010252900015970930201,410 -
Xsuthaotriiz�ul " FAB-103 0 812
I decluee�unde pena ties of perjury that this is a true,correctalid compl tum. ' f
Date 1 t/ Phone/I �-7 ` F Total Sales of Food&Beverages(Do Not Include Tax) A. `rTL
Total Exempt Food&Beverage Sales B.
CITY OF CARMEL BROOKSHIRE GOLF COUR
CARMEL UTILITIES Net Taxable Sales(Subtract Line Bfrom Line A) C.
Taxpayer ID Number For Tax Period Tax Due(1%of Line C) D.
SEP 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. 1 0
OCT 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 Carmel-29291 *The 2014 Annual Interest Rale is 3%
Adjustments(An explanation must be attached) H.
L�LI�I�I���ILILI���1113��II�L�11
Total Amount Due(Total Lines F and G plus or minus H)' I. l
INDIANA DEPARTMENT OF REVENUE
P•0. BOX 7229
INDIANAPOLIS, IN 46207-7229
L1��1�1113��I�IIL��LI�II���L�I�L�LIIII����I�ILIt�11���1 0800001113554951010252929115970930201410
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Forth 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
07, 0j"y Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
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 $
1�"(c, 46307
$ to
ON ACCOUNT OF APPROPRIATION FOR
FLvud -�jo &(37A
Board Members
Po#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s),
,(p 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
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund