HomeMy WebLinkAbout185614 05/25/2010 CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF REVENUE
CARMEL, INDIANA 46032 Po eox 7229 CHECK AMOUNT: $242.84
INDIANAPOLIS IN 46207 CHECK NUMBER: 185614
CHECK DATE: 5125/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 242.84 F B -GOLF 04/10
B-103 0809
si"... �X& 64fm
I dec lare under pcnmlr this "a true correct mid cojuple k1l".
Dutc hQl,,u)ueZ_ALt Total Sales ol'Food Bevera (Do Not Include Include Tax) A. ]Z 3
Total Exempt Food Bevera Sales B.
BROOKSHIRE GOLF CLUB Net Taxable Sales (Subtract Line 1.1 front Line A) C. q 3
CARMEL UTILITIES
Taxpayer I D Number For Tax Period Tax Due I 'Yo of Line C) 1). 7-)
0003120155 004 0 APR 2010 Collection Allowance (.73% ol'Line D)
Do Not Use this Line it'llie Paviiieril is Lale E.
County/Town Due on or Before Nei Tax Due (Subtract Line E from Litle 1)) F. 1
Penally is Grealerol'$5 or 10% of F (plus Interest)"
Hamilton MAY 31 2010 Use this Hite 0111V ifrelLu'll is filed late G.
Mic 201 Auntial liter" Rule is 4%,
AdjLlSlllletl[S (Ail explanation Must be attached) H
Toial Amouni Due (Total Lines F and G plus or rnitlus 11) 1.
INDIANA DEPARTMENT OF REVENUE
P•0• BOX 7229
INDIANAPOLISiIN 46207-7229
080000113554950010252900015970430201008
4utlinriird
B -103 0809
tiiRnurare
declare a lid cr pens �o that this is atruc. correct and comp I rrn.
Date f Q Phone o J �J 71 2 I
Total Sales of Food Be erages (Do Not Include Tax)......... A. 7 4 3
Total Exempt Food Beverage Sales B.
BROOKSHIRE GOLF CLUB y i
Net Taxable Sales (Subtract Line B f rom Line A) C. 1 J 1 q
CARMEL UTILITIES Z Z�j l
Taxpayer ID Number For Tax Period 1' axDue (I %of Line C)
D.
0003120155 004 0 APR 2010
Collection Allowance (73% of Line D)
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.
Penalty is Greater of $5 or 10% of Line F (Plus Imerest)•
Hamilton MAY 31 2010 Uset his line only ifreturiis filed late G.
'The 2010 Annual Interest Rate is 4%
I I I I I I Adjustments (An explanation must be attached).. H
r r t r r n n I r n I r u Total Amount Due (Total Lines F and G plus or minus H) L$
INDIANA DEPA OF REVENUE
P.O. BOX 7229
INDIANAPOLIS,IN 46207 -7229
Irinlrllrnrlrlllrulnrllnrinlrinlrllrinnl�llrl 08000 0113554950010252900 01597 04302
i
j �ati,ar E "f --10 3 0809
Xtzae are
I declare under enat s 1p,,jury that this is at rue. correct and omplet et nt, Z
_7 l F Total Sales of Food Beverages (Do Not Include Tax)......... A. L
I
'Total Exempt Food Beverage Sales
BROOKSH IRE GOLF CLUB Net Taxable Sales (Subtract Line B from Line A) C• V
CARMEL UTILITIES Z Z 3
Taxpayer ID Number For Tax Period Tax Due (1 %of Line C) ..I............................ D.
0003120155 004 0 APR 2010 Collection Allowance (.73 in of Line D)
Do Not Use this Line ifthe Payment is Late
County /Town Due on or Before Net Tax Due (Subtract Line F from Line D F.
Penalty is Greaterof$5 or 10 %of Line F (Plus Interest)
Carmel MAY 31 2010 Use this line only ifreturn is tiled late_ G.
`The 2010 Armual interest Rare is 4
Adjustments (An expianation must be auached)
t
Irrlrlrlrl,rrrllrlJrr tllrrrlllirtrl
Total Amount Due (Total Lines F and G plus or minus H) I. l /i
1 INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7229
INDIANAPOLIS,IN 46207 -7229
Ir 080000113554951 ❑102529291159704302 ❑1008
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form 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.
P ee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
S
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
2�kz.�
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoi 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