HomeMy WebLinkAbout217921 03/12/2013 CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 1
`• ONE CIVIC SQUARE INDIANA DEPT OF REVENUE
CHECK AMOUNT: $0.13
CARMEL, INDIANA 46032 Po aox 7229
INDIANAPOLIS IN 46207 CHECK NUMBER: 217921
CHECK DATE: 3/1212013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 GOLF 2/13 1 . 13 F & B TAX-GOLF 2/13
alt FAB-103 0812
XAgnatured , R
Sgnature �•
I declar u tde\r penalttiiiee-s�of pequty thaljhis is a true,cc rrrrect and complete
Date 1 y- 1r/ Phone j✓��M �,l( �� Total Sales of Food&Beverages(Do Not Include Tax) A.
Total Exempt Food&Beverage Sales B. y
BROOKSH IRE GOLF CLUB
CARMEL UTILITIES Net Taxable Sales(Subtract Line B from Line A) C. /
I v 2
Taxpayer ID Number For Tax Period Tax Due(I%of Line C) D. J
FEB 2013 Collection Allowance(.73%of Line D)
0003120155 004 0 Due on or Before Do Not Use this Line if the Payment is Late E.
APR 01 2013 Net Tax Due(Subtract Line E from Line D) F.
Penalty is Greater of$5 or 10%of Line F(Plus Interest)*
County/Town Use this line only ifretum is filed late G.
❑Check if Amended Hamilton-29000 *The 2013 Annual Interest Rate is3%
Adjustments(An explanation must be attached) H
It tltl tl�Itlln�I�lutt�lltt�Iluli�I Total Amount Due(Total Lines F and G plus orminusH) I.
INDIANA DEPARTMENT OF REVENUE
P.0• BOX 7229
INDIANAPOLIS, IN 46207-7229
IILIIIIIIIII 080000113554950010252900015970228201302
XAo.hor,=ed A z, F AB-1[13 0 812
5,ature
I declare nder penalties of perjury that this is a true,correct and con'plete re[u r
Date s� Phone I �L- Total Sales of Food&Beverages(Do Not Include Tax) A.
BROOKSHIRE GOLF CLUB Total Exempt Food&Beverage Sales B.
CARMEL UTILITIES Net Taxable Sales(Subtract Line B from Line A) C. (p
Taxpayer ID Number For Tax Period Tax Due(]'/c of Line C) D. 0
FEB 2013 Collection Allowance(.73%o£Line D)
0003120155 009 0 Due on or Before Do Not Use this Line if the Payment is Late E.
APR 01 2013 Net Tax Due(Subtract Line E from Line D) F.
Penalty is Greater of$5 or 10%of Line F(Plus Interest)*
County/Town Use this line only if return is tiled late G
❑Check if Amended Carmel-29291 *The 2013Anmta Interest Rate is3%
Adjustments(An explanation must be attached) H
Itt l tltltlilltttl�Itnitllutllttlltl 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
It I..It llt���Itlll���l���ll���l��I,Ittllll�l�t�tltll�lt�ll���l 08000011355 4951010252929115970228201302
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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
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
$
Inds I&I Lj�,;�a 7- 7 '
$ / 3
ON ACCOUNT OF APPROPRIATION FOR
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
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund