192653 12/10/2010 CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF REVENUE CHECK AMOUNT: $101.74
CARMEL, INDIANA 46032 PO BOX 7229
INDIANAPOLIS IN 46207
CHECK NUMBER: 192653
CHECK DATE: 12/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 GOLF F B 101.74 F B -GOLF 11 /10
X Aprhorir.e4 r 3�
signaNre �sF` 1 1` F T•'
declare and r pen I[ es of perjury that this is a true. correct and ao ntplet n,
Total Sales of Food Beverages (Do Not Include Tax).. A. I a3 5
Date I 1,/ Phone p (,�b r.J F O
Total Exempt Food Beverage Sales B.
BROOKSHIRE GOLF CLUB r
Net Taxable Sales (Subtract Line B from Line A) C.
CARMEL UTILITIES
Taxpayer ID Number For Tax Period Tax Due 0 ofLine C) D.
0003120155 004 0 NOV 201p Collect ion Allowance(. 73% of Line D) r�
Do Not Use this Line ifthe Payment is Late E. -J
County /Town Due on or Before Net Tax Due (Subtracl Line o from Line D F.
Penalty is Greater of S5 or 10/a of Line F (Plus InteresL)
Hamilton DEC 30 2010 Use this line only ifretumis Filed l ate G. l
•The 2010 Annual Interest Rate is 4
Adjustments (An explanation must be att ached) H,
11, I l l 111 l I ii I I l I l l i e l l l l l l ie l l l l l 111 Total Amount Due (Total Lines F and G plus or minus H) 1.$ W
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7229
INDIANAPOLIS,IN 46207 -7229 rI 7 ry I�
111111 111111111I live 1111111 11111 11111111111 080000113554950010252900015971130 1010
1 AB -1 03 0809
X Authori> C nl j M l�
sig aNr 0 `L.E .�/sr i
I declare under er penalties ofperjury that this is a true. correct and complet return. 1
Date 1 Phone a; f 3l �j ;W focal Sales of Food &Beverages (Do Not Include Tax)......... A. 1 hh !l
Total Exempt Food Beverage Sales B. L' 0
BROOKSHIRE GOLF CLUB /5 2
Net Taxable Sales (Subtract Line B from Line A) C. J J
CARMEL UTILITIES a
Taxpayer ID Number For Tax Period lax Due (1% ofLine C)—, D.
0003120155 004 0 NOV 2010 Collection Allowance (.73% of Line D)
Do Not Use this Line ifthe Payment is Late E. 3 7
County /Town Due on or Before Net Tax Due (Subtract Line E from Line D) IF.
Penalty is Greater of S5 or 10% of Line F (Plus Interest)* p 7
Carmel DEC 30 2010 Use this line only ifreium is filed late G. O
'The2010 Annual Interest Rate is 4%
(I I I I I l I I l l l l I Adjustments (An explanation must be attached) H.
11 1 1 1 111 11 111 11 111 111
INDIANA DEPARTMENT OF REVENUE Total Amount Due (Total Lines F and G plus or minus H) I. rt�? 7
P.O. BOX 7229
INDIANAPOLIS,IN 46207 -7229 ryr� p 71� y
11i111 11I1111I11III t11111111111111111111111111111111111 ,111111 0 8 0 0 0 0 1 1 3 5 5 4 5 1 0 1 0 2 5 2 1 2 9 J1 1 5 9 7 1 1 3 0 2 0 1 0 1 0
I
CITY OF CARMEL
Brookshire Golf Course
Calculation of Sales and Food Beverage Taxes Owed
November 30, 2010
Total Non Taxable Taxable
Sales Sales Sales
Green Fees 16,011.20 16,011.20 0.00
Membership Fees 36,575.00 36,575.00 0.00
Cart Fees 4,528.03 4,528.03
Member Cart Fees 2,990.69 2,990.69
Gift Cards Sold 3,967.00 3,967.00 0.00
Pro Shop Non Taxable 0.00 0.00 0.00
Pro Shop Taxable 2,316.07 2,316.07
Food and Beverage Non Taxable 0.00 0.00 0.00
Food and Beverage Taxable 5,123.95. 5,123.95
Total 71,511.94 56,553.20 14,958.74
Total Non Taxable Taxable Tax
Sales Sales Sales Payable
Sales Tax 71,511.94 56,553.20 14,958.74 1,047.11
Interest 0.00
Penalty 0.00
Collection Allowance (7.64)
1,039.47
Carmel Hamilton
Total Non Taxable Taxable FAB Tax FAB Tax
Sales Sales Sales Payable Payable_
FAB Tax 5,123.95 0.00 5,123.95 51.24 51.24
Interest 0.00 0,00
Penalty 0.00 0.00
Collection Allowance (0.37) (0.37)
50.87 50.87
Total Period Sales Taxes Owed 1,039;47
Total Period FAB Taxes Owed 101.74
1,141.21
Taxes collected 347060 172.42
347070 526.32
347080 409.87
1,108:61
(32.60) netioss on tax collection
Prescribed by Slate 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.
Payee
E (2LA)t4 Purchase Order No.
o ���X '30 Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
kDA f tu
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.
�j QfJ ALLOWED 20
G v IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
6at LAj r 0(), AWP
Board Members
POM or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT- I hereby certify that the attached invoice(s), or
'L �v (C) 7- q 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
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund