HomeMy WebLinkAbout206940 03/13/2012 CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF REVENUE
CARMEL, INDIANA 46032 PO BOX 7229 CHECK AMOUNT: $2.32
INDIANAPOLIS IN 46207
CHECK NUMBER: 206940
CHECK DATE: 3/13/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 2/2 -GOLF 2.32 GOLF -2/12
Food and Beverage Tax or County Supplemental Food and Beverage Tax
(Instructions for completing Form FAB -103)
The following instructions are to assist you in completing Form FAB -103. The instructions are valid for this form only.
A. Total Sales Enter the total receipts from food and beverage sales. Do not include sales tax or food and beverage tax on this line.
B. Total Exempt Sales Enter the total exempt food and beverage sales. This figure cannot be greater than the amount on Line A.
C. Net Taxable Sales Subtract Line 13 from Line A. This figure must never be greater than Line A.
D. Tax Due Multiply Line C by the county tax rate. listed on your return. If there is an entry on this line, there must be entries on Line A and Line C.
E. Discount (Collection Allowance) Use this line only if your return is postmarked on or before the due date. The discount is available only
when the payment is remitted timely. For further information, please refer to this Web site: www.in.gov /dor /3618.htm
F. Net Tax Due Subtract Line E from Line D.
Q Penaltyfinterest Due A payment made after the due date is subject to penalty and interest on the total on Line D. The penalty is 10 percent
of the total on Line D, or $5, whichever is greater. To calculate interest, multiply the amount due by the annual interest rate and divide the result by 365.
Multiply that result by the number of days the payment is late. Interest is computed from the due date of the return to the date payment is made. Interest
is not computed on the penalty.
H. Adjustments Adjustments can be an overpayment or underpayment. If Line H has a negative entry, use a negative sign. A negative adjustment
must have an explanation attached or the adjustment will be disallowed. This line cannot be greater than the amount due.
1. Total Amount Due Add Lines F and G plus or minus Line H. Include this amount with your return.
Please do not send cash. Make check payable (in U.S. funds) to the Indiana Department of Revenue.
91 V411%
FAB -103 0811
X �gn.wR A
IdWaa apen.lPa>rNif itih v j ylieel.n�dap��h�_
Date Phone J 2 Total Sales of Food Beverages (Do Not Include Tax) A, 2-
I
BROOKSHIRE GOLF CLUB Total Exempt Food Beverage Sales B.
CARMEL UTILITIES Net Taxable Sales (Subtract Line B from Line A) C. 2 3 l� I
i 3 Taxpayer ID Number For Tax Period Tax Due (1% of Line C) D.
Collection Allowance (.73% of Line D) y y
0003120155 004 0 n— nn or Before Do Not Use this Line if the Payment is Late E. [J
—7
Net Tax Due (Subtract Line E from Line D) F. 3
County /Town penalty is Greater of $5 or 10% of Line F (Plus Interest)'
Use this line only if return is filed late G.
CheCk if Amended Hamilton 29000 *The 2012 Annual Interest Rate is 4
I t r Adjustments (An explanation must be attached H.
11 I t l t l t l t l l u t l l l i t t 11 I l t t t l It t 111 I Total Amount Due (Total Lines F and G plus or minus H)_.........
INDIANA DEPARTMENT OF REVENUE
P.O. 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.
Payee
KI& Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
6 tax_._
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
�o U
IN SUM OF
C
ON ACCOUNT OF APPROPRIATION FOR
Fur'
C 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
f9° Law 20
d
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund