HomeMy WebLinkAbout214507 11/14/2012 CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF REVENUE
CHECK AMOUNT: $108.39
CARMEL, INDIANA 46032 PO BOX 7229
INDIANAPOLIS IN 46207 CHECK NUMBER: 214507
CHECK DATE: 11/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 GOLF 10/12-2 108 . 39 F & B TAX-GOLF 10/12
XSlutt,oi FAB-103 0811
1 decijaze nder penaltie eTl NY s a. �cyrrc co p
Date I 3 Z Phone SI—�' I` 0 1 Total Sales of Food&Beverages(Do Not Include Tax)......... A. I 0 I �`
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.
OCT 2012 Collection Allowance(.73%of Line D) i
0003120155 004 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)* C/
County/Town Use this line only if return is filed late..................................... G. Z>
❑ Check if Amended Carmel *The 2012 Annual Interest Rate is 4%
II I I I I Adjustments(An explanation must be attached)...................... H.
1 Total Amount Due(Total Lines F and G plus or minus H) I.
INDIANA DEPARTMENT OF REVENUE
P•0• BOX 7229
INDIANAPOLIS,IN 46207-7229
08000011,3554951,01,02529291,15971031,201203
- —--------
FAB—10 3 0 811
XAuthorized
t".'"
I declare and penalties of perjury that this is a true correct and comp,
Date Total Sales of Food&Beverages(Do Not Include Tax)......... A. V I
I( hone � 1
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) ( a
Do Not Use this Line if the Payment is Late............................ E. l I
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.
ln(� Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
i
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.
e ALLOWED 20
Aj lad IN SUM OF $
TO -7,La
ON ACCOUNT OF APPROPRIATION FOR
6W aod- �jd )manoTo
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
� C( l09 Z� 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
/d,
Signa ure
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund