HomeMy WebLinkAbout217922 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 BOX 7229
INDIANAPOLIS IN 46207 CHECK NUMBER: 217922
CHECK DATE: 3/12/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 GOLF 2/13 2 . 13 F & B-GOLF 2/13
X Authorized '��
, FAB-103 0812
Signature _
I declar uu td Perjury ef perju that}}his is a true,correct and complete
�G'jy' '
Date Phone l( Total Sales of Food&Beverages(Do Not Include Tax) A.
z-/ �t�
Total Exempt Food&Beverage Sales B. n
BROOKSHIRE GOLF CLUB Net Taxable Sales(Subtract Line B from Line A) C. ( j
CARMEL UTILITIES
Taxpayer ID Number For Tax Period Tax Due(1%of Line C) D•
FEB 2013 Collection Allowance(.73%ofLine D)
Do Not Use this Line if the Payment is Late E,
0003120155 004 0 Due on or Before % 3
APR Ol 2013 Net Tax Due(Subtract Line E from Line D) E• l .1
Penalty is Greater of SS or 10%of Line F(Plus Interest)*
County/Town Use this line only if return is filed late G.
❑Check if Amended Hamilton-29000 "The 2013 Annual ntcrest Rate is3%
{ Adjustments(An explanation must be attaclted) H,
I I I I I I I I I n I l I l I n I I I l I I I I i n I l I l Total Amount Due(Total Lines F and G plus or ininus H)_ I• J
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7229
INDIANAPOLIS, IN 46207-7229
III IIIIIIIII IIIIII IIIIIIIIIIIIIIIIIIII IIIII IIIIIIIIIIIII III III 080000113554950010252900015970228201302
XAmhonzed ° 1
FAB-103 0812
$gnatore
I declare nder penalties of perjury that ttthis is a true,correct an'it lete r f r
17 Date Phone Total Sales of Food&Beverages(Do Not Include Tax)
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• /—
FEB 2013 Collection Allowance(.73%of Line D)
Do Not Use this Line if the Payment is Late E.
0003120155 009 0 Due on or Before i
APR 01 2013 Net Tax Due(Subtract Line E from Line D) P.
Penalty is Greater of S5 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 2013 Annual interest Rate is 31X,
Adjustments(An explanation must be attaclted) H.
u 1 I I I l I l I I I n I I t I I I I n I l I t I 1 I I I(III Total Amount Due(Total Lines F and G plus or minus H)
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7229
INDIANAPOLIS, IN 46207-7229
11IIII1111IIII11111IIIII1111 IIlIIIIIIII1111IIIIIIIII11111{IIII 080000113554951010252929115970228201302
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.
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.
r ALLOWED 20
INS SUM U $
-P0
ON ACCOUNT OF APPROPRIATION FOR
,,d A&
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
Signat
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund