HomeMy WebLinkAbout201111 09/12/2011 CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 1
i ONE CIVIC SQUARE INDIANA DEPT OF REVENUE
CARMEL, INDIANA 46032 PO BOX 7226 CHECK AMOUNT: $184.47
INDIANAPOLIS IN 46207 CHECK NUMBER: 201111
CHECK DATE: 9/12/2011
DEPARTMENT ACCOUNT PO NUMBER INVOI NUMBER AMOUNT DESCRIPTION
101 5023990 2 184.47 F B -GOLF 8/11
p
Aaraori, FAB —10 3 0 810
X sip—,
I declare unde Pay atties oIperjury that this is a true, correct and co, rcluni, 3
Q' I, Total Sales of Food Beverages (Do Not Include Tax).......,. A. I
Date phone 3 7'
Total Exempt Food Beverage Sales B.
BROOKSHIRE GOLF CLUB Net Taxable Sales (Subtract Line B from Line A) C. l D
CARMEL UTILITIES
Taxpayer ID Number For Tax Period Tax Due I of [-me C). D.
Collection Allowance (.73% of Line D)
OD0312Di55 009 0 AUG 2U11 Do Not Use this L ine ifthe Payment isLate E.
County /Town Due on or Before Pe na l ty is ue (Subtract Line tLine F from Line D)..,... F.
r 10 %of Line F (Plus Interest)'
Hamilton SEP 30 2011 Use this line only ifreium is filed late G.
"The 2011 Annual Interest Rate is 9 "/n
Adjustments (An explanation must be attached) H.
Itrltlililrrrlrllnrltrlltutlliulll Total Amount Due (Total Lines F and G Plus or minus IT) 1. A�
INDIANA DEPARTMENT OF REVENUE
P•0• BOX 7229
INDIANAPOLIS,IN 46207 -7229
I�LrI�II��ttlJllt��lr��ll��tl�rl�l��1111 ,III�Jhllrl�tlltt�l 0800001 1355495231325292001 ,5970831201109
4u11—i d r FAB —10 3 0 810
I decla�u der enaIties al perjury that this is a true, correct and c ipl return,
666
Total Sales of Food Beverages (Do Not Include Tax)......... A. b 7y
Date Phone ��l
Total Exempt Food Beverage Sales B.
BROOKSHIRE GOLF CLUB K 3 3
Net Taxable Sales (Subtract [.ine B from Line A) C.
CARMEL UTILITIES 3
Taxpayer ID Number For Tax Period Tax Due 1% of Line C) D. Collection
0003120155 009 U AUG 2011 E. r 3
All nce (.73% of Line D)
Do Not Use tl s Line ifihe Payment is Late
County /Town Due on or Before Nei Tax Due (Subtract Line E from Line D). F.
Penalty is Greater of S5 or 10% of Line F (Plus Interest)'
Carmel SEP 30 2011 Use this line only if return is filed late G.
"The 2011 Annual Inheres Rate is 9
Adjustments (An explanation must be attached) 11,
Irrliltlrlr�rlrllriilrtllrrerllrttll) Total Amount Due (Total Lines F and G plus or minus 14) 1. I L
INDIANA DEPARTMENT OF REVENUE
P.0- BOX 7229
INDIANAPOLIS,IN 46207 -7229
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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.
Ifs I Paye
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
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ere y
DEPT. ACCT #/TITLE AMOUNT 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