172701 05/26/2009 CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF REVENUE CHECK AMOUNT: $104.74
{a CARMEL, INDIANA 46032 PO BOX 7226
INDIANAPOLIS IN 46207 CHECK NUMBER: 172701
CHECK DATE: 5/26/2009
DEPA RTMENT ACCO PO NUMBER INVOICE N UMBE R AMOUNT DESCR IPTION
101 5023990 F B —APRIL 104.74 F B —APRIL 09 GOLF
f
FAB -103 080 I
nun, Z D
Sig_,_ Total Sales of Food Beverages (Do Not Include Tax)......... A.
I declare under penalties ol'perjury Utat this is a true, correct and con a return,
7 Total Exempt Food Beverage Sales B. V L V
Date P ho ne Phone d F 5 o
Net Taxable Sales (Subtract Line B from Line A) C. 7
BROOKSHIRE GOLF CLUB Tax Due (1 %of Line D. C D 2- I -7
CARMEL UTILITIES Collection Allowance (.73% ofLine D) 3
Taxpayer ID Number For Tax Period Do Not Use this Line ift he Payment is Late
E.
0003120155 044 0 APR 2009 2 3
Net Tax Due (Subtract Line E from Line D) P.
Penalty is Greater of $5 or 10% of Line F (Plus Interest)*
County /Town Due on or Before U se this line only ifretumis filed late G.
Hamilton JUN 01 2009 'The 2009 Annual Interest Rate is 7%
H
Adjustments (An explanation most be attached) R.
f I �j
I„Irl,l,lnnll,l,l,ul,lll,nl,lul Total Amount Due (Total Lines F and G plus or minus ll) L$
INDIANA DEPARTMENT OF REVENUE
P -0• BOX 7229
INDIANAPOLIS,IN 46207 -7229
04660011355495001025043020090601200909
I
FAB -103 0808 r
X Aurhorieed r
s+ Total Sales of Food &Beverages (Do Not Include Tax)......... A.
I declare under pen• 16 I'perjury that this is a true. correct and complete ,r
c j, Total Exempt Food &Beverage Sales B. d✓
Date: Net k�� Pho rie (f� 1� `J V
Net Taxable Sales (Subtract Line B from Line A) C. r 2 0
BROOKSHIRE GOLF CLUB Tax Due 0 %of Line C) D. rj Z -7
I CARMEL UTILITIES Collection Allowance (.73% of Line D)
Taxpayer ID Number For Tax Period Do Not Use this Line fthe Payment isLate E.
0003120155 004 0 APR 2009 r -7
Net Tax Due (Subtract. Line E from Line D) F.
County /Town Due on or Before Pena €tyis Greater of $5or10 %ofLineF (Plus Interest)*
C a r me I JUN 01 2009 Use this line only ifretum is filed late G.
'The 200 Annual Irnerest Rate is 7%
Adjustments (An explanation must be attached) H.
1n1 ,1,1,1r,r,11,1,i,n1,111n,1,1n1 Total Amount Due (Total Lines F and G plus or minus IT) I. 2.31
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7229
INDIANAPOLIS,IN 46207 -7229
04000011355495161025043020090 601200904
CITY OF CARMEL
Brookshire Golf Course
Calculation of Sales and Food Beverage Taxes Owed
April 30, 2009
Total Non Taxable Taxable
Sales Sales Sales
Green Fees 33,285.84 33,285.84 0.00
Membership Fees 8,432.00 8,432.00 0.00
Cart Fees 5.00 5.00
Member Cart Fees 0.00 0.00
Pro Shop Non Taxable 2,241.25 2,241.25 0.00
Pro Shop Taxable 2,665.26 2,665.26
Food and Beverage Non Taxable 850.00 850.00 0.00
Food and Beverage Taxable 5,276.20 5,276.20
Total 52,755.55 44,809.09 7,946.46
Total Non Taxable Taxable Tax
Sales Sales Sales Payable
Sales Tax 52,755.55 44,809.09 7,946.46 556.25
Interest 0.00
Penalty 0.00
Collection Allowance (4.06)
552.19
Carmel Hamilton
Total Non Taxable Taxable FAB Tax FAB Tax
Sales Sales Sales Payable Payable
FAB Tax 5,276.20 0.00 5,276.20 52.76 52.76
Interest 0.00 0.00
Penalty 0.00 0.00
Collection Allowance (0.39) (0.39)
52.37 52.37
Total Period Sales Taxes Owed 552.19
Total Period FAB Taxes Owed 104.74
656.93
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.
c Payee
aw nt LL 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
C'WALFiJ Ft� O t h ff2
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
j� 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
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund