HomeMy WebLinkAbout200219 08/10/2011 CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 1
0 ONE CIVIC SQUARE INDIANA DEPT OF REVENUE CHECK AMOUNT: $166.93
CARMEL, INDIANA 46032 PO BOX 7229
'c, row INDIANAPOLIS IN 46207 CHECK NUMBER: 200219
CHECK DATE: 8/10/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 GOLF F B 1 166.93 GOLF F B 7/11
X Authuri,ed
FAB -103 0810
sig -rue
I declar, der _enalties of perjury that this is a true, correct and com t turn. Q
f r` Total Sales of Food Beverages (Do Not Include Tax)_....... A. I I V
I Date�_t_ Phone ti3�_
E Total Exempt Food Beverage Sales B. I Q
t BROOKSHIRE GOLF CLUB Net Taxable Sales (Subtract Line B from Line A)-- C. 1(J S IU
CARMEL UTILITIES j
Taxpayer ID Number For Tax Period Tax Due (I% of Line C) D. 4�
Collection Allowance (.73 of Line D)
0003120155 004 0 JUL 2011 I
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)*
Hamilton AUG 30 2011 Use this line only If retum is filed late..... G.
"The 2011 Annual latere t Rae is 1 1%
Adjustments (An explanation must be attached) H,
1 1,1111111 n 111111111 n l 11, n l l n 1111 Total Amount Due (Total Lines F and G plus or minus H) I• 1
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7229
INDIANAPOLIS,IN 46207 -7229
11111L111111111111111,11 ►,111111,1111111111111111111111 0800001135549503102529032
i
Aaµa AB —103 0 810
signnturc
I declare un er penalties a['perjury that this is a true. correct and cmaplet et
Date Phone Total Sales of Food &Beverages (Do Not Include Tax A. 1 tf� v 10
Total Exempt Food Beverage Sales B.
j BROOKSHIRE GOLF CLUB CJ-
i_
Net Taxable Sales (Subtract Line B from Line A) C. f0 a I 1� O
CARMEL UTILITIES
Taxpayer ID Number For Tax Period Tax Due 0% of Line C) D. t�
Collection Allowance (.73% of Line D)
0003120155 004 0 JUL 2011 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 SS or 10 %of Line F (Plus Interest)*
Carmel AUG 30 2011 Use this line only ifretnm is fled late... G.
*The 2011 Annual Interest Rate is 95/,,
Adjustments (An explanation must be attached) H.
1,11, I ,111111111111111111111111111111 Total Amount Due (Total Lines F and G plus or minus h[)
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7229
INDIANAPOLIS,IN 462 07 -7229
1111111111,n1111 11111 ,1111111 080000 0252929115970731201105
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.
/7 IIll Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
11 0
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
ON ACCOUNT OF APPROPRIATION FOR
6t4
Board Members
PO# or INVOICE NO, ACCT #ITITLE 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
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund