HomeMy WebLinkAbout182625 02/18/2010 CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF REVENUE
PO BOX 7226 CHECK AMOUNT: $6.02
CARMEL, INDIANA 46032
INDIANAPOLIS IN 46207 CHECK NUMBER: 182625
Pox
CHECK DATE: 2/18 12010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 F B 01 /10 6.02 F B -GOLF 01/2010
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Aulhnri,. r 0 8 0 9
Signant :e
I declare u dtr enalties ofperjury that this is a true, correct and c o I n i plete to
Date Phone &I I" �'t1 F Total Sales of Food &Beverages (Do Not Include Tax)._...... A.
Total Exempt Food &Beverage Sales B.
�fb�D
BROOKSHIRE GOLF CLUB y, ,I'
Net Taxable Sales (Subtract Line B from Line A) C. o
CARMEL UTILITIES .3
Taxpayer ID Number For Tex Period Tax Due (1 %of Line C) D•
0003120155 004 0 JAN 2010 Collection Allowance (.73 %of Line D)
Do Not Use this Line if the Payment is Late E.
Count /Town Due on or Before Net Tax Due (Subtract Line E front Line D) F.
"3 a 1
y Penalty is Greater of S5 or 10% of Line F (Plus Interest)*
Carmel MAR 02 2010 Use this line only ifretumisfiledlate C,
*The 2010 Annual Irttereri Rate is 4%
Adjustments (An explanation must be att ached) H,
l t�l�I�I1111 ln1�1l�t�l�llu�llll��tl Total Amount Due (Total Lines F and G plus or minus H) f• �.D
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 72
INDIANAPOLIS,IN 46207 -7229
Itl��l�ll����l�lll��� l���II�„I��I l�11�II�Ir��tl�ll�1�111���1 080000113554951010252929115970 131201002
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Aa hot rte v —10 3 0809
1 'SignaNre
i
I declare under p naIt➢es ofperjury that this is a true. correct and cot et return.
Date Phone W 4 5 1 F Total Sales of Food Beverages (Do Not Include Tax)......... A.
BROOKSHIRE GOLF CLUB
Total Exempt Food &Beverage Sales B.
fry
CARMEL UTILITIES Net Taxable Sales (Subtract Line B from Line A) C. V
Taxpayer ID Number For Tax Period Tax Due 0 %of Line C) D. J�
0003120155 004 0 JAN 2010 Collection Allowance(. 73 %ofLineD)
Do Not Use this Line if the Payment is Late E.
County /Town Due on or Before Net Tax Due (Subtract Line E from Line D) F. H
Penalty is Greater of $5 or 10% of Line F (Plus Interest)*
Hamilton MAR 02 2010 Use this line only ifretumis filed late G.
*The 2010 Annual Interest Rate is 4
t
I I I I I I I I! I I I I I Adjustments (An explanation must be attached) H.
INDIANA DEPARTMENT OF REVENUE Total Amount Due (Total Lines F and G plus or minus H)
P.O. BOX 7229
INDIANAPOLIS,IN 46207 -7229
080000113554950010252900015970131201002
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.
Paye
Purchase Order No.
e
Terms
1
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
t ru `Z
Total
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
VO,UCHER NO. WARRANT NO.
ALLOWED 20
N SUM OF
oZ
ON ACCOUNT OF APPROPRIATION FOR
�b Zip
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT I her c that the attached invoices or
In DEPT. Y Y
2--AqU Z 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
/7
20
Sign re
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund