167782 01/20/2009 CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 1
a ONE CIVIC SQUARE INDIANA DEPT OF REVENUE CHECK AMOUNT: $8,866.86
CARMEL, INDIANA 46032 PO BOX 7218
oMi INDIANAPOLIS IN 46207 -7218 CHECK NUMBER: 167782
CHECK DATE: 1/20/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NU AMOUNT DESCRIPTION
1047 4359200 PARKS 8,866.86 SALES TAX PAID 2008
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NA Total Sales....... I. Z,
V A,nhe Exemptions/ Deductions .2.
Idccla�c ndn pmaAies ofpetjury th ,;sa�u�. aaa �rz t, Taxable Sales (line 1 -2) 3. p p 91 Id
Daie Phone i 31 7) ,x-73 -Hoa Total Tax Due 7% ofluie3 .......................4.:
Discount (Collection Allowance) .................5, LA S a C
CARMEL CLAY PARKS AND RECREATION Use Tax Due (7% X Purchases) ...................6.
Taxpayer ID Number For Tax Period
0119683083 001 7 JAN THRU DEC 2008 Interest Due (Lune 4 Line 6 x I nt Rate) 7.
2W8 Annual lnt—i Ram is 7 °io
Filing Status Due on or Before Penalty Due............
ANNUAL FEB 02 2009
11 11EE Payment Previously Made (EFT .................9.:
I11 ll�llillllllllllllllllllllllllllll Amount Due
INDIANA DEPARTMENT OF REVENUE (Add Lines 4 +6 +7 +S minus5 &9) JoS
P.O. Box 7218
INDIANAPOLIS, IN 4620 -7218
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ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
Indiana Department of Revenue Terms
P.O. Box 7218 Date Due
Indianapolis, IN 46207 -7218
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/1/09 0119683083 001 7 Sales tax paid for period Jan thru Dec 2008 8,866.86
Total 8,866.86
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.
Indiana Department of Revenue Allowed 20
P.O. Box 7218
Indianapolis, IN 46207 -7218
In Sum of
8,866.86
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT i AMOUNT Board Members
Dept TITLE
1047 0119683083 001 7 4359200 8,866.86 1 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
14 -Jan 2009
Signature
8,866.86 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund