166058 11/19/2008 CITY OF CARMEL INDIANA VENDOR: 00350929 Paige 1 of 1
ONE CIV[C SQUARE INDIANA DEPT OF REVENUE
CARMEL, INDIANA 46032 PO 60x 7229 CHECK AMOUNT: $210.24
INDIANAPOLIS IN 46207
CHECK NUMBER: 166058
CHECK DATE: 11/1912008
DEPARTMENT AC PO NUMBER INVOI NUMBER AMOUNT DE
101 5023990 T 210.24 F B TAX 10/08
FAB -103 0807
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Total Sales of Food &Beverages (Do Not Include Tax) A. 1 Q 5 7 8 7 b
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X A�mori:ed Total Exempt Food Beverage Sal es B.
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b tamt �eun aer nie: orpmu .we,cereaanacomPletevuu =ner. Net TaxableSales( SubtractLineBfromLineA .................C. l Q
o Date Phone
BROOKSH IRE GOLF CLUB Tax Due 1 of Line C) D. Q 5
Collection Allowance (.83 of Line D)
CARMEL UTILITIES Do Not Use this Line if the Payment is Late E. 1
Taxpayer 1D Number For Tax Period
0003120155 004 0 OCT 2008 Net Tax Due (Subtract Line E from Line D) F. Q 5 Z
County /Town Due on or Before Penalty is Greater of $5 or 10% of Line D (Plus Interest)*
HAMILTON DEC 01, 2008 Use this line only if return is filed l ate G.
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The cuuent annual int—SL Late for late payments s 7
Adjustments (An explanation must be attached) H.
U �tt�t�t�t�tn��ut��nlltt�tttltt�tl Total Amount Due (Total Lines F and G plus or minus H)I.
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V INDIANA DEPARTMENT OF REVENUE
P. 0. BOX 7229
INDIANAPOLIS, IN 46207 -7229
0400001135549500 10251031,20081201200804
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W FAB -103 0807
0
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b Total Sales of Food &Beverages (Do Not Include Tax) A. o
e
a XAUmurizM Total Exempt Food Beverage Sales B.
m Signature 44
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E; l d«l.re wde> i �,ttalt;es nep<riur mat mis i wc, —t.na eomple,e voucner. Net Taxable Sales (Subtract Line B from Line A) C.
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g
Date Phone rr
N BROOKSH IRE GOLF CLUB Tax Due 1 of Line C) G
D. J
Collection Allowance (.83% of Line D)
CARMEL UTILITIES Do Not Use this Line if the Payment is Late E.
Taxpayer ID Number For Tax Period
Net Tax Due Subtract Line E from Line D F. ii
0003120155 004 0 OCT 2008 l Q Z
County /Town Due on or Before Penalty is Greater of $5 or 10% of Line D (Plus Interest)*
o Use this line only if return is filed late. G.
CARMEL DEC O1, 2008
ne ...rent annual -,—t,w foo late payments is. 7%
Adjustments (An explanation must be attached) H.
V ��t�t�t�t�en��ntl�tt��et��nt�n�t� Total Amount Due (Total Lines F and G plus or minus H)I.
INDIANA DEPARTMENT OF REVENUE
P. 0. BOX 7229
INDIANAPOLIS, IN 46207 -7229
04000011355495101025 103120081201200810
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CITY OF CARMEL
Brookshire Golf Course
Calculation of Sales and Food Beverage Taxes Owed
October 31, 2008
Total Non Taxable Taxable
Sales Sales Sales
Green Fees 35,290.44 35,290.44 0.00
Membership Fees 2,462.34 2,462.34 0.00
Cart Fees 3,092.02 3,092.02
Member Cart Fees 44.00 44.00
Pro Shop Non Taxable 4,070:00 4,070.00 0.00
Pro Shop Taxable 6,377.95 6,377.95
Food and Beverage Non Taxable 436.13 436.13 0.00
Food and Beverage Taxable 10,588.78 10,588.78
Total 62,361.66 42,258.91 20,102.75
Total Non Taxable Taxable Tax
Sales Sales Sales Payable
Sales Tax 62,361.66 42,258.91 20,102.75 1,407.19
Interest 0.00
Penalty 0.00
Collection Allowance (10.27)
1,396.92
Carmel Hamilton
Total Non Taxable Taxable FAB Tax FAB Tax
Sales Sales Sales Payable Payable
FAB Tax 10,588.78 0.00 10,588.78 105.89 105.89
Interest 0.00 0.00
Penalty '0.00 0.00
Collection Allowance (0.77) (0.77)
105.12 105.12
Total Period Sales Taxes Owed 1,396.92
Total Period FAB Taxes Owed 210.24
1,607.16
Prescribed by State 2a+d 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
i2w Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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
�j Lfwv
O,o
ON ACCOUNT OF APPROPRIATION FOR
Aw
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
A 4 A I A &adfL,
ignature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund