HomeMy WebLinkAbout165055 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF REVENUE
g 0 CHECK AMOUNT: $277.00
PO BOX 7229
CARMEL, INDIANA 46032 INDIANAPOLIS IN 46207 -7229 CHECK NUMBER: 165055
CHECK DATE: 10/16/2008
DE A PO NUMBE I NVOI CE NUMBER A MOUNT DESCRIPTI
101 5023990 277.00 F T TAX -SEPT 2008
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FAB -103 0807
Total Sales of Food Beverages (Do Not Include Tax) A.
�auh�r Total Exem t Food Bevera e Sales B.
P g
sigoaz t I '1
Idechre under penh Upej„r.�,ha� tnis l:, t oe. e— and cumple�e euehen� Net Taxable Sales(Subtract Line B from Line A) .C. "I Jc q
Date Phone 7
Tax Due I of Line C) D.
BROOKSHIRE GOLF CLUB Collection Allowance (.83% ofLine D) I C
CARMEL UTILITIES Do Not Use this Line if the Payment is Late. E.
Taxpayer ID Number For Tax Period Q
0003120155 004 0 SEP 2008 Net Tax Due (Subtract Line E from Line D) F.
ty hown Due on or Before Penalty is Greater of $5 or 10% of Line D (Plus Interest)*
Coun
CA OCT 30, 2008 Use this line only if return is filed late G.
Tl,e -mr�nt anic,:d uAt, s ,Far lace p�j;nents is T/a
m Adjustments (An explanation must be attached) H.
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Total Amount Due (Total Lines F and G plus or minus H)1. J
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INDIANA DEPARTMENT OF REVENUE
P. 0• BOX 7229
INDIANAPOLIS, IN 46207 -7229
04000011355495101025093020081030
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Fold on perforation before tearing
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FAB —10 3 0 8 0 7 _.4�.
Total Sales of Food Beverages (Do Not Include Tax).. A. I 3
X n�moraea Total Exempt Food Beverage Sales.....'-.. B.
td-Isre wader peaa ;'ar na manh,.« e. eo� ana— pie,e. --he, Net Taxable Sales (Subtract Line B from Line A) C.
Date Phone
Tax Due I of Line C) D.
BROOKSHIRE GOLF CLUB Collection Allowance (.83% of Line D) I
CARMEL UTILITIES Do Not Use this Line if the Payment is Late E'
L
Taxpayer ID Number For Tax Period
0003120155 004 0 SEP 2008 Net Tax Due (Subtract Line E from Line D) F. Ci
County /Town Due on or Before Penalty is Greater of $5 or 10% of Line D (Plus Interest)*
HAMIL'I'ON OC'1' 30, 2008 Use this line only if return is filed l ate G.
ne ceneu�v -i :nee,e ,late io, late ya rnen[s s 7%
C3 Adjustments (An explanation must be attached) H.
Inl t ltl,l.nlltlltutl�tlllntlul�l Total Amount Due (Total Lines F and G plus or minus H)I.
INDIANA DEPARTMENT OF REVENUE
8 P• 0. BOX 7229
Q
INDIANAPOLIS, IN 46207 -7229
0
0400001135549500 102509302008103020081,0
0
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3
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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(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
I IN SUM OF
�77
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #!TITLE 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
Signatur
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund