HomeMy WebLinkAbout219626 05/07/2013 CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 1
0 j• ONE CIVIC SQUARE INDIANA DEPT OF REVENUE CHECK AMOUNT: $64.38
CARMEL, INDIANA 46032 PO Box 7229
INDIANAPOLIS IN 46207 CHECK NUMBER: 219626
CHECK DATE: 5/7/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 64 .38 F & B-GOLF 4/13
XAuthorized
W ✓ FAB-103 0812
s , tre 'Of
—169
1 dedarere'un er penalties of perjury that this-iiss)a true,correct and comple urn
Date �� Phone t / Total Sales of Food&Beverages(Do Not Include Tax), A. [//J
Total Exempt Food S Beverage Sales B.
BROOKSHIRE GOLF CLUB Net Taxable Sales(Subtract Line B from Line A)_ C. �` 4g,
CARMEL UTILITIES
Taxpayer ID Number For Tax Period Tax Due(I%of Line C) D.
APR 2013 Collection Allowance(.73%of Line D)
Do Not Use this Line if the Payment is Late E.
0003120155 004 0 Due on or Before
MAY 30 2013 Net Tax Due(Subtract Line E from Line D) F.
Penalty is Greater of$5 or 10%of Line F(Plus Interest)*
ff�� County/Town Use this line only if return is filed late G. l
u Check if Amended Hamil ion-29000 `The 2013 Annual Interest Rate is 31.S,
Adjustments(An explanation must be attached) H.
11111111111 n 1111111111111 n 111111111 Total Amount Due(Total Lines F and G plus or minus H)
INDIANA DEPARTMENT OF REVENUE
P.O. BOX 7229
INDIANAPOLIS, IN 46207-7229
111111 1111111111111111111111111111111111111111111111111.1'111111 080000113554950010252900015970430201300
Xs,o,h�rared A B-10 3 0 812
I ded.,:el r penalties of perjury that this is a true,correct and complete to
Date Phone r�`' F Total Sales of Food&Beverages(Do Not Include Tax) A.
Total Exempt Food&Beverage Sales B.
BROOKSHIRE GOLF CLUB
Net Taxable Sales(Subtract Line B from Line A) C.
CARMEL UTILITIES G S
Taxpayer ID Number For Tax Period Tax Due(1%of Line C)_ D.
APR 2013 Collection Allowance(.73%ofLine D) �
Do Not Use this Line 1 f the Payment is Late_ E.
0003120155 004 0 Due on or Before
MAY 30 2013 Net Tax Due(Subtract Line E fi-om 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-29291 'The 2 2013 Annual Interest Rare is 3%
Adjusnnents(An explanation must be attached) H.
Iu 1111111 r11111111111111111111111111 Total Amount Due(Total Lines f and G plus or minus H) I. kJ ✓
INDIANA DEPARTMENT OF REVENUE
P-0- BOX 722.9
INDIANAPOLIS, IN 46207-7229
111111111111111111111 11111111111111111111111111111111111111111 080000113554951010252929115970430201300
Prescribed by State Board of Accounts City Form No.201(Rev 1995)
ACCOUNTS PAYABLE VOUCHER
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))
F 41a ��13L
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
n IN SUM OF $
9�q
IJ 463o-7- 7 A
$ J�
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