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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