HomeMy WebLinkAbout184616 04/21/2010 CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF REVENUE
CHECK AMOUNT: $86.54
i• r CARMEL, INDIANA 46032 PO 80X 7229
INDIANAPOLIS IN 46207 CHECK NUMBER: 184616
CHECK DATE: 4/2112010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 86.54 F B -GOLF 03/10
X Y Aon,�ri,.�a �.Ur, 9 B-103 0 8 0 9
1 5ignamre
I de h[s hf�ece o reFU p
phone F i— Total Sales oCFOOd Beverages (Do Not Include 3'ax) A. Da[e p �j
Total Exempt Food Beverage Sales B.
BROOKSHIRE GOLF CLUB 't j Sj 3
Net Taxable Sales (Subtract Line B from Line A) C.
CARMEL UTILITIES 3`
Taxpayer ID Number for Tex Period Tax Due (I %of Line C) D.
4
0003120155 004 0 MAR 2010
Collection Allowance (.73% of Line D)
3
E
Do Not Use this Line ifthe Payment is Late E.
Count /Town Due on or Before Net Tax Due (Subtract Line E from Line D F.
County/Town Penalty is Greater of S5 or 10 %oFLine F (Plus Interest)"
Carmel APR 30 2010 Use this line only ifretum is filed late_ G. `1
'The2010 Annual Interest Rate is1
Adjustments (An explanation must be attached) H.
r I I r I r l r I n n l l U l l I I l u r n l l 111 r r r l Total Amount Due (Total Lines F and G plus or minus H) 1 4 1 .Z
INDIANA DEPARTMENT OF REVENUE
I P.O. BOX 7229
I INDIANAPOLIS,IN 46207 -7229
i irlrrlrlllr Illll��r tltt�rlrllrLrlltr�l 080000113554951010252929115970331201010
I
I
X Au
�1 B -103 0809
[hori y
Segna[ure
I declare nder penalties ofperjury that this is a tm correct and conrpl turn. �^7 .rte
Date l o phone L7g F Total Sales of Food Beverages (Do Not Include Tax)......... A. `f 1 1
Total Exempt Food Beverage Sales B. i
BROOKSHIRE GOLF CLUB
CARMEL UTILITIES Net Taxable Sales (Subtract Line B from Line A) C. `t i
Taxpayer ID Number For Tax Period Tax Due (1% of Line Q D. l 3 G I
Lf
0003120155 004 0 MAR 2010 Collection Allowance (,73 %ofLineD)
Do Not Use this Line ifthe Payment is Late._ E,
County /Town Due on or Before Net Tax Due (Subtract Line E from Line D) F.
Penalty is Greater of S5 or 10% of Line F (Plus Interest)' '�j
Hamilton APR 30 2010 Use this line only ifretum is filed late G.
"The 2010 Annual Interest Rate is 4%
I I I I I III I I I I I Adjustments (An explanation must be attached) H.
r r r r t r r r t r r i r r r r r r r o r Total Amount Due (Total Lines F and G plus or minus FI) I. L� 7 7
INDIANA DEPARTMENT OF REVENUE l •c 1
P-O- BOX 7229
INDIANAPOLIS,IN 46207 -7229
Iilrrl Ilrrrrlt lllurlrrrllrrrlr ,lrltilrllrlr�rrlrllrlrrlllrll 082000113554950 010252900015970331201010
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
r
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
S o�
4 Iv
Total Lj
1 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
ZIP JA IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Ap"a
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
i 20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund