HomeMy WebLinkAbout208549 05/02/2012 CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 1
p ONE CIVIC SQUARE INDIANA DEPT OF REVENUE CHECK AMOUNT: $111.51
CARMEL, INDIANA 46032 PO Box 7229
INDIANAPOLIS IN 46207 CHECK NUMBER: 208549
CHECK DATE: 5/2/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 F& B -GOLF 2 111.51 F& B -GOLF 4/12
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AB-103
0 811
X A Signature
1 declare enalties of perjury that thi a true, correct and complete 6
Date Phone l L5-7 ��-1' I Total Sales of Food Beverages (Do Not Include Tax) A.
Total Exempt Food Beverage Sales B.
BROOKSHIRE GOLF CLUB 3
CARMEL UTILITIES Net Taxable Sales (Subtract Line B from Line A) C. I t
Taxpayer ID Number For Tax Period Tax Due (I% of Line C) D.
APR 2012 Collection Allowance (.73% of Line D)
0003120155 009 0 Due on or Before
Do Not Use this Line if the Payment is Late E.
MAY 30 2012 Net Tax Due (Subtract Line E from Line D) F. I I I I
Penalty is Greater of S5 or 10% of Line F (Plus Interest)*
County /Town Use this line only if retum is filed late G.
Check if Amended Carmel 'The 2012 Annual Interest Rate is 4%
Adjustments (An explanation must be attached) H.
I tilt l titit�ttll�ltltt�tll���ll��l�ll Total Amount Due (Total Lines F and G plus or minus H)
INDIANA DEPARTMENT OF REVENUE
P•0• BOX 7229
INDIANAPOLIS,IN 46207 -7229
I�I��It llt ��tl�lll���l�t �llt ��l� tl�l��l�ll�l�tt�ltll�ll�ll���l 080000113554951010252929115970430201210
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XSig^atu:ed F A B -10 3 0 811
1 declare u er enalties ofperjury that this is a true, correct an comp) e r rn. 2 v
Date 1 2 Phone l 1 I V 3 Total Sales of Food Beverages (Do Not Include Tax)......... A. t�
BROOKSHIRE GOLF CLUB Total Exempt Food Beverage Sales B.
CARMEL UTILITIES Net Taxable Sales (Subtract Line B from Line A) C.
Taxpayer ID Number For Tax Period Tax Due (I %of Line C) D.
APR 2012 Collection Allowance (.73% of Line D)
0003120155 004 0 Due on or Before Do Not Use this Line if the Payment is Late E.
MAY 30 2012 Net Tax Due (Subtract Line E from Line D) F. I
Penalty is Greater of $5 or 10% of Line F (Plus Interest)*
County /Town Use this line only ifreturn is filed late
G.
Check if Amended Hamilton 'The 2012 Annual Interest Rate is 4%
I I I I I I Adjustments (An explanation must be attached) H.
INDIANA DEPARTMENT OF REVENUE
Total Amount Due (Total Lines F and G plus or minus H) I.
t
P.O. BOX 7229
INDIANAPOLIS,IN 46207 -7229
080000113554950010252900015970430201210
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.
Pay�
t
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
DEPT INVOICE NO. 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
0
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund