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HomeMy WebLinkAbout214506 11/14/2012 CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 1 ONE CIVIC SQUARE INDIANA DEPT OF REVENUE CARMEL, INDIANA 46032 PO BOX 7226 CHECK AMOUNT: $108.39 INDIANAPOLIS IN 46207 CHECK NUMBER: 214506 CHECK DATE: 11/1412012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 101 5023990 GOLF 10/12-1 108 . 39 F & B TAX-10/12 X5 th.,e° FAB—1x 0 3 0 811 I declare nder penalti -eta ,t a e, 9" 7co`p ,/� (� Date ���Z phone�,:6 l I L/ i Total Sales of Food&Beverages(Do Not Include Tax)......... A. U I (} BROOKSHIRE GOLF CLUB Total Exempt Food&Beverage Sales................................... B. (� Net Taxable Sales(Subtract Line B from Line A)................... C. CARMEL UTILITIES Taxpayer ID Number For Tax Period Tax Due(I%of Line .................................................. D. OCT 2012 Collection Allowance(.73%of Line D) I 0003120155 009 0 Due on or Before Do Not Use this Line if the Payment is Late............................ E. NOV 30 2012 Net Tax Due(Subtract Line E from Line D)............................ F. Penalty is Greater of S5 or 10%of Line F(Plus Interest)* County/Town Use this line only if return is filed late..................................... G. ❑ Check if Amended Carmel *The 2012 Annual nterest Rate is ai II I I I I Adjustments(An explanation must be attached)...................... H. t t I I I Total Amount Due(Total Lines F and G plus or minus Fl) I. 1 O •3 INDIANA DEPARTMENT OF REVENUE P•0• BOX 7229 INDIANAPOLIS,IN 46207-7229 I�I��I�II����I�III���I�1111��11��1�1111�11�11�1�1�1111��11��11 0800001,135549510 1025292917,5971[031201203 L _ a Y Autho nzed FAB-1 03 0811 f Signawre I declare'nd penalties of perjury that this is a true correct and comp! re M. l—� � Date ;.) 7 Total Sales of Food&Beverages(Do Not Include Tax)......... A. V � � hone {_/! Total Exempt Food&Beverage Sales................................... B. BROOKSHIRE GOLF CLUB Net Taxable Sales(Subtract Line B from Line A)................... C. CARMEL UTILITIES Taxpayer ID Number For Tax Period Tax Due(1%of Line C).................................................. D OCT 2012 Collection Allowance(.73%of Line D) i Q Do Not Use this Line if the Payment is Late............................ E. 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 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice( ) or bill(s)) �f-7 log. 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 n. Board Members Po#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or C) Z Q 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