HomeMy WebLinkAbout191919 11/17/2010 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: $292.72
INDIANAPOLIS IN 46207 CHECK NUMBER: 191919
CHECK DATE: 11/17/2010
DEPARTMENT ACCOUNT PO NUMBER I NVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 F B -GOLF 292.72 F B -GOLF 10 /10
Aata�r ,�d c B 10 3 0809
I declare ,m r pei Iuesopp �u`��t"trt�is i�t8 +sef�ic' et d complete ret
Date phone �J
Total Sales of Food Bey- erages (Do Not Include Tax)......... A. I 7 v
k I� 1 i
111 Total Exempt Food Beverage Sales B.
BROOKSHIRE GOLF CLUB �r
Net Taxable Sales (Subtract Line 8 from Line A) C. I `T 7 q
CARMEL UTILITIES LD
Taxpayer ID Number For Tax Period T%x Due (1 %of Line C)........._ D. I q7 r 1
0003120155 004 0 OCT 2010 Do
Not Use th
I iisLineifthePaym P is E. t
ern is Late....._
County /Town Due on or Before Nei Tax Due (Subtract Line E from Line D) F. I�
Penalty is Greater of 55 or 10% of Line F (plus Interest)'
Hamilton NOV 30 2010 Use this line only ifretumis filed late G.
'Tile 2010 Annual Interest Rute is a✓,
Adjustments (An explanation must be attached) H.
II, I, I,I,In,IInrIIHl,llu,lllln,l Total Amount Due (Total Lines F and G Plus or minus H) I. 6 3
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7229
INDIANAPOLIS,IN 46207 -7229
Irl„Irll,,,,I, III,,, I„, IIII ,I,Il,lnl,llrl„r,l,llll „II„rl 08000 0113554950010252900015971031201001
'4
I
T F.AB -103 0809
x A N
M,,6,cd
gnuNrr
I decla under penalties ol'perjun thw this is a true. correct and complete ret 'y r
Date pt q
I phone 9 Total Sales of Food &Beverages (Do Not Include Tax) A. 1J p(
Total Exempt Food &Beverage Sales B.
BROOKSHIRE GOLF CLUB a
Nei Taxable Safes (Subtract Line B from Line A) C.
CARMEL UTILITIES
Taxpayer ID Number For Tax Period Tax Due (I %of Line C) D. 1 T
0003120155 004 0 OCT 2010 Collection Allowance (_73 %ofLineD) /l b
Do Not Use this Line if the Payment is Late E. (JJ o
County /Town Due on or Before Net Tax Due lSubtraci Line E from Line D F. 1 b 3t,
Penalty is Greater of S5 or 10 of Line F (Plus [merest)”
Carme 1 NOV 30 2010 Use this line only ifretum is filed late G.
'The 2010 Amoral Interest Rate is 9%
F Adjustments (An explanation must be attached) H.
,,Irlrlrl,l,llnrllnluln,Illln,l
Total AmoumDue (Total Lines F and G plus or minus H)
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7229
INDIANAPOLIS,IN 46207 -7229
I,Ir,lrll„„I, III,,, I„, II ,,,I„I,Inl,llrin„I,II,I„II,,,I 080000113554951010252929115971031201001
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))
Z.v O
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
7 749
'b /?M-5 7L.1 q�a7z) 7 2d2l
7j 7a
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoices 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
r o- 20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund