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Home My WebLink About256935 03/31/16 CITY OF CARMEL, INDIANA VENDOR: 147005 ONE CIVIC SQUARE INDIANA DEPT OF REVENUE CHECK AMOUNT: $*******175.00* CARMEL, INDIANA 46032 FUEL&ENVIRONMENTAL DIVISION CHECK NUMBER: 256935 Miro cp 5150 DECATUR BLVD INDIANAPOLIS IN 46241.9564 CHECK DATE: 03/31/16 DEPARTMENT ACCOUNT PO NUMBER - INVOICE NUMBER AMOUNT DESCRIPTION 2201 4358300 3/31/16 175.00 OTHER FEES & LICENSES •,tip Form Indiana Department of Revenue SF-801 Alternative Fuel Decal Application dz State Form 46292 (R5/3-14) Name(as shown on vehicle registration) Federal Identification or Social Security Number.(must be provided) City of Carmel Street Department FED ID# 356000972 _Address City State ZIP Code 3400 W. 131st Street Carmel �IN 46074 Annual Motor Carrier or IFTA Permit Number(if applicable) 017 Registered Vehicle Year Make Model Current Date of Type Registered Vehicle Tax Rate Identification Odometer Purchase, of Gross Category from Rate Number Reading Conversion, Fuel Weight _ Number Schedule or Used Registration 1.' 1FTBF2B60FEC46708 2015 FORD F-250 6561 6/23/2015 LP 10,000 3 $175.00 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. Total Decals Ordered 1 Tax Due $175.00 For Department Use Only For Department Use Only Category Number From To Check Amount Check Number Keep copies of this application form in each vehicle until you receive your decals! Under the penalty of perjury, I have examined this return(including accompanying schedules and statements)and,to the best of my knowledge and belief, it is true, co lete, and correct Taxpayer or Authorized Agent: C �� Date: 6-30-2015 Telephone Number: 317733-2001 Type or Print Name: Dave Huffman Title: Street Commissioner ❑ Please Check Box If Last Filing Date Business Closed Instructions for Completing Alternative Fuel Decal Application What Is Alternative Fuel? What Happens if I Purchase a Decal and Then.Later Sell or Dis- "Alternative fuel" means a liquefied petroleum gas used in an in- pose of My Vehicle? Do I Get a Refund? ternal combustion engine or motor to propel any form of vehicle, A prorated credit may be given toward the fee for a decal for an- machine,or mechanical contrivance. The term includes all forms other vehicle or for a subsequent 12 months if the decal is sur- of fuel commonly or commercially known or sold as butane or rendered to the department or unused. Credits may not be.given propane. during the last 3 months before the decal expires. Please contact the department for specific information on credits. Refunds of NOTE: Effective Jan. 1, 2014, natural gas-powered vehicles (fuel the decal fee are not allowed per the law. commonly or commercially known or sold as compressed natural gas[CNG]or liquefied natural gas[LNG])are no longer required to What if I'm Just"Passing Through"Indiana? purchase or display alternative fuel tax decals. The owner of a motor vehicle propelled by alternative fuel that is registered outside of Indiana and is operated on a public highway Who Needs to Purchase a Decal? in Indiana is not required to obtain a decal. A temporary trip per- The owner of a motorvehicle that is registered in Indiana and that mit may be purchased from a licensed propane dealer who sells is propelled by alternative fuel must obtain an alternative fuel de- alternative fuels. A temporary trip permit is valid for 72 hours cal for the motor vehicle and pay an annual fee. Each registered -from the time of purchase for a specific registered vehicle. The motor vehicle powered by alternative fuel is required to have a fee for each permit is$5.50. decal: • Passenger motor vehicles,trucks,or buses weighing less Are There Any Exemptions from This Tax? than 9,000 pounds As in the past,decals are normally not needed for alternative fuel • Recreational vehicles used: • Trucks or buses weighing more than 9,000 pounds but 1. In Indiana by the United States government; equal to or less than 11,000 pounds 2. By a municipal public transportation corporation estab- • Alternative fuel delivery trucks powered by alternative lished under IC 36-9-4 for the compensated transporta- fuel weighing more than 11,000 pounds tion of persons within the corporation's territory; • Trucks or buses weighing more than 11,000 pounds,ex- 3. By a municipal public transit department for the paid cept for an alternative fuel delivery truck transportation of persons within the service area;and • A tractor designed to be used with a semi trailer 4. By a common carrier of passengers, including certain taxicabs, that transports passengers within one specific The alternative fuel decal shall be affixed to the lower-left side of area within Indiana and meets certain other require- the front windshield of the motor vehicle for which it was issued. ments. If you believe you qualify for this exemption, The decal may be displayed only on the motor vehicle for which please contact-the department for further details. the decal was issued. Who Can I Call or Contact if I Have Questions? How Much Are the Decals? You may contact the Fuel Tax Section of the Indiana Department The.annual fee for the decal is based upon the type and weight of Revenue by phone at(317) 615-2630 Monday through Friday. of the vehicle. The fees range from$100 to$500. Please see the between 8:15 a.m. and 4:30 p.m. You also can email the depart- following rate schedule: ment at fetax0donin.gov. To contact the department by mail, write to: How Long Is the Decal Valid? Decals are valid from April 1 of each year through March 31 of the Indiana Department of Revenue next year. The expiration date may be extended for up to 30 days. P.O.Box 6080 Indianapolis, IN 46206-6080 Can the Decal Fee Be Prorated? The annual fee may be prorated on a quarterly basis if the applica- tion is made after June 30 of a year and the vehicle is newly con- verted to alternative fuel, newly purchased, or newly registered in Indiana. Rate Schedule If Purchased During Vehicle Category April-June July-Sept. Oct.-Dec. Jan.-March . 1. A passenger motor vehicle,truck, or bus,the declared gross weight of which is equal to or less than 9,000 pounds. $100.00 $75.00 $50.00 $25.00 2. A recreational vehicle. $100.00 $75.00 $50.00 $25.00 3. A truck or bus,the declared gross weight of which is greater than 9,000 pounds but equal to or less than 11,000 pounds. $175.00 $131.25 $87.50 $43.75 4. An alternative fuel delivery truck powered by alternative fuel, the declared gross weight of which is greater than 11,000 pounds. $250.00 $187.50 $125.00 $62.50 5. A truck or bus,the declared gross weight of which is greater than 11,000 pounds, except an alternative fuel delivery truck. $300.00 $225.00 $150.00 $75.00 6. A tractor designed to be used with a semi trailer. $500.00 $375.00 $250.00 $125.00 Prescribed by State Board of Accounts City Form 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 Purchase Order No. Terms Date Due Invoice Date Invoice# Description Amount Dept. Fund# (or note attached invoice(s) or bill(s)) 03/25/16 0 $175.00 2201 201 I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 INDIANA DEPT OF REVENUE FUEL & ENVIRONMENTAL DIVISION IN SUM OF$ 5150 DECATUR BLVD INDIANAPOLIS, IN 46241-9564 $175.00 ON ACCOUNT OF APPROPRIATION FOR Street Department PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Member: I 0 I 43-583.00 I $175.00 1 hereby certify that the attached invoice(s), or 2201 201 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 Tuesday, March 29, 2016 0 It )n I All &t44,4 Street Commissioner Cost distribution ledger classification if claim paid motor vehicle highway fund