173614 06/10/2009 "4 CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF REVENUE
CHECK AMOUNT: $237.32
CARMEL, INDIANA 46032 Po aox 7229
INDIANAPOLIS IN 46207 CHECK NUMBER: 173614
1'
CHECK DATE: 6/10/2009
J
DEPARTMENT AC PO NUMBER IN NU MBER AMOUNT DESCRIPTION
101 5023990 F B TAX 237.32 F B TAX 05/09 T
CITY OF CARMEL
Brookshire Golf Course
Calculation of Sales and Food Beverage Taxes Owed
May 31, 2009
Total Non Taxable Taxable
Sales Sales Sales
Green Fees 89,795.36 89,795.36 0.00
Membership Fees 1,109.00 1,109.00 0.00
Cart Fees 0.00 0.00
Member Cart Fees 0,00 0.00
Pro Shop Non Taxable 0.00 0.00 0.00
Pro Shop Taxable 4,293.43 4,293.43
Food and Beverage Non Taxable 239.00 239.00 0.00
Food and Beverage Taxable 11,953.09 11,953.09
Total 107,389.88 91,143.36 16,246.52
Total Non Taxable Taxable Tax
Sales Sales Sales Payable
Sales Tax 107, 389.88 91,143.36 16, 246.52 1,137.26
Interest 0.00
Penalty 0.00
Collection Allowance (8.30)
1,128.96
Carmel Hamilton
Total Non Taxable Taxable FAB Tax FAB Tax
Sales Sales Sales Payable Payable
FAB Tax 11,953.09 0.00 11,953.09 119.53 119.53
Interest 0.00 0.00
Penalty 0.00 0.00
Collection Allowance (0.87) (0.87)
118.66 118.66
Total Period Sales Taxes Owed 1,128.96
Total Period FAB Taxes Owed 237.32
1,366.28
FAB 0808
X AuiMn,rd 9,
sinr: Totai Sales of Food Beverages (Do Not Include Tae) A. I J 1 S J D
E declare under penalties u!'perjury that this is a true, correct and complete re a.
J Total Exempt Food Beverage Sales B.
Date Phone# 4� G6 71 4 F
Net Taxable Sales (Subtract Line B from 1_ine A) C. G I I cJ q
BROOKSHIRE GOLF CLUB Tax Due II of Linec).......__ D. �3
CARMEL UTILITIES Collection Allowance(. 73 %ofLineD) g
Taxpayer ID Number For Tax Period Do Not Use this Line ifthe Payment isLate
6003120155 004 0 MAY 2009 F 7 b
Net Tae Due (Subtract Line E front Line D)
Before Penalryis Greater orS5or10 %ofLineF(PlusInterest)*
County /Town Due on or
Carmel JUN 30 2Be Use this line only ifretumis filed late G.
'The N09 Annual Interest Rate is 7%
Adjustments (An explanation must be attached)
IIIIII��I It n�l�ll�l��ltll�l Total Amount Due (Total Lines F and G plus or minus H) 1.
INDIANA DEPARTMENT Of REVENUE
P.O. BOX 7229
INDIANAPOLIS,IN 46207 -7229
04000011355495101025053 ],20090630200910
FAB -103 0808 1it
MUM
X sig.turr, W Total Sales of Food Beverages (Do Not Include Tax) A. I f q 5, o q
I declare u der p1iialues of-perjury that this is a true. correct and comp etum.
I Total Exempt Food Beverage Sales B.
Date IP�_ Phone F+ Net Taxable Sales (Subtract Line B from Line A) C. I l 3 0 9
II Q
BROOKSHIRE GOLF CLUB Tax Due (1 %of Line C) I r
CARMEL UTILITIES Colleclion Allowance (.73 %ofLineD) g
Taxpayer ID Number For Tax Period Do Not Use this Line ifthe Payment is Late E.
0003120155 004 0 MAY 2609
Net Tax Due (Subtract Line E from Line D) F. I I CJ
t
ifr
l
line
Penalty is Greater of $5 or 10 %of Line F (Plus Interest)*
County /Town Due on or Before Use this only eum is riled [ate
Hamilton JUN 30 2009 G.
'The 2009 Amoral Interest Rate is 7
ee 11 Adjustments (An explanation must be attached) H.
Total Amount Due (Total Lines F and G plus or minus H) L$
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7229
INDIANAPOLIS,IN 46207 -7229
04000011355495001025053120090630200904
Prescribed by Slate'�-rd of %blunts 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.
A Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
s T(0=
Total 3
1 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
&Ua� Iy�
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
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund