HomeMy WebLinkAbout187110 06/24/2010 CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF REVENUE
CARMEL, INDIANA 46032 PO BOX 7229 CHECK AMOUNT: $225.50
INDIANAPOLIS IN 46207
CHECK NUMBER: 187110
CHECK DATE: 6/24/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 FOOD 05/10 225.50 F B -GOLF 05/10
X Aulhorisiy
r —103 0809
SignaNrr
declare under pe naltiies afperjury that this is a true, correct and eontplcte
Da[ r g',�
L•�j a 7 f 2 qt f�1 Total Sales of Food Beverages (Do Not Include Tai)......... A. z5 y I
Phoned 1 1
BROOKSHIRE GOLF CLUB
Total Exempt Food Beverage Sales B.
CARMEL UTILITIES
Net Taxable Sales (Subtract Line B from Line A) C.
Taxpayer ID Number For Tax Period Tax Due (I %of Line D.
0003120155 004 B MAY 2014 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 cf S5 or 10% of Line F (Plus Interest)*
Hamilton JUN 30 2010 Use this line only ifretumisf iiled late G.
'The 2010 Annual lnterest Rate is 4
Adjustments (An explanation must be attached) H.
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Total Amount Due (Total Lines F and G plus or minus H) I.
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7229
I INDIANAPOLIS,IN 46207 -7229
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i
X Aiahnrired
F —103 0809
Signature
I declare under penalties orperjury that this is a true. correct and complete
Phone g:�O s� z Total Sales of Food &Beverages (Do Not Include Tax)--- A. 1
Date
Total Exempt Food Beverage Sales B.
BROOKSHIRE GOLF CLUB I 3'�
Net Taxable Sales (Subtract Line B from Line A) C
C.
CARMEL UTILITIES
Taxpayer ID Number For Tax Period Tax Due 0% of Line C)........_...._ D.
Collection Allowance (.73% of Line D) S
0003120155 004 0 MAY 2010 Do Not Use this Lin ifthe Payment is Late E. o
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% of Line F (Plus Interest)"
Carmel JUN 30 2010 Use this line only ifretumisfiled late. G•
'The 2010 Annual interest Rute is 4
Adjustments (An explanation must be attached)........ H.
IttIJJllttttl[Itt[nullt,tllllt tl Total Amount Due (Total Lines F and 6 plus or minus H) I.
INDIANA DEPARTMENT OF REVENUE
P.0• BOX 7229
INDIANAPOLIS,IN 46207 -7229
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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 Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s)
4
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
J �j bZo� ---W
ON ACCOUNT OF APPROPRIATION FOR
jo
4w o Board Members
PO# or INVOICE NO. ACCTWTITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
�JQZ Z2Sg3 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
S
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund