HomeMy WebLinkAbout224754 10/07/2013 CITY OF CARMEL, INDIANA VENDOR: 00350929 Page 1 of 1
ONE CIVIC SQUARE INDIANA DEPT OF REVENUE
CARMEL, INDIANA 46032 PO BOX 7229 CHECK AMOUNT: $148.93
`? INDIANAPOLIS IN 46207
CHECK NUMBER: 224754
CHECK DATE: 10/7/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 148 . 93 F & B TAX-GOLF 9/13
Authorized j ; e }`�° W
t' F A B—10 3 0812
X Signature rIAX
I declaredunder pen Iri s• e,Corr) qc nipl e ret
Date Phone 7� v Total Sales of Food&Beverages(Do Not Include Tax) A.
Total Exempt Food&Beverage Sales B.
BROOKSHIRE GOLF CLUB
CARMEL UTILITIES Net Taxable Sales(Subtract Line B from Line A) C. CJ
Taxpayer ID Number For Tax Period Tax Due(1%o£Line C) D. V 0
SEP 2013 Collection Allowance(.73%ofLine D) I I O
0003120155 004 0 Due on or Before Do Not Use this Line if the Payment is Late E. Q
OCT 30 2013 Net Tax Due(Subtract Line E from Line D) F.
Penalty is Greater of S5 or 10%of Line F(Plus Interest)*
County/Town Use this line only ifremm is Fled late G.
❑ Check ,if Amended Hamilton-29000 *The 2013 Annual Interest Rate is 3%
Adjustments(An explanation must be attached) H
Iii 1111111111 1 1111 1 1 n 111 it 11111,1111 Total Amount Due(Total Lines F and G plus or minus H)—_ I. (�i 0 .
INDIANA DEPARTMENT OF REVENUE
P•0• BOX 7229
INDIANAPOLIS, IN 46207-7229
11111111111111111111111111111111111111111111111111111111111111 080000113554950010252900015970930201309
XYAuthorized ! a �e FAB—10 3 0 812
1�Sipature
I declare and r penaItie-ofpep t at t s is ,c fr rplete rent �"
Date W 13;13 Phon 1 �I � Total Sales of Food&Beverages(Do Not Include Tax) A. I p� 502
Total Exempt Food&Beverage Sales B.
BROOKSHIRE GOLF CLUB
Net Taxable Sales(Subtract Line B from Line A) C. t ,�o 0
CARMEL UTILITIES ( ) t 3
Taxpayer ID Number For Tax Period Tax Due 1%ofLine C D. C�s 19
SEP 2013 Collection Allowance(.73%ofLine D) 1
Do Not Use this Line if the Payment is Late _ E. t t
0003120155 004 0 Due on or Before
OCT 30 2013 Net Tax Due(Subtract Line E from Line D) F. 4
Penalry is Greater of$5 or 10%of Line F(Plus Interest)*
County/Town Use this line only if return is filed late G.
❑ Check if Amended Carmel-29291 `The 2013 Annual Interest Rate is 3%
Adjustments(An explanation must be attached) H
11,1111111 n 11111(n I Tl 11111111111111 Total Amount Due(Total Lines F and G plus or minus H)_ I. ( L.1�$ 9 2
. INDIANA DEPARTMENT OF REVENUE ✓
P•0. BOX 7229
INDIANAPOLIS, IN 46207-7229
11111111111111111111111111111111111111111111111111111111111111 0 8 0 0 0 0 1 1 3 5 5 4 9 5 1 0 1 0 2 5 2 9 2 9 1 1 5 9 7 D 9 3 0 2 0 1 3 0 9
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.
IPayee
L -- Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
- Zo 13 g. 3
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 $
,macs -2,07
$
ON ACCOUNT OF APPROPRIATION FOR
C-7F—Ko
Board Members
PO#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
(D l Sv 9p I 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
Signatur
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund