2003-06-25 CC Packet - Laserfiche WebLink

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Min'nesota Lawful Gambling Schedule C/D - LG1010 General Information Organization Name Organization License Number SPRING LAKE PARK LIONS CLUB 00584 Month and year reported 4/2003 Page 2 of 2 pages Schedule C: Lawful Purpose Expenditures Current Monthly I i ! Membershio Date of I Check I Is this an amended Schedule C/D? Y N A I For Code! A-7 Only i I Approval Date I Check ! Number! Check made out to: TRCS! Code I M F! Amount I I I I 4/4/2003 I 12593 i SPRINGLAK PARK HIGH SCHOOL I I 3/27/2003 A-4 5000.00 I I 3/27/2003 4/4/2003 I 125941 HISTORY DAY SUPPORT CLUB - ST PAUL A-7B X x! I 80.80 ! i 1/23/2003 4/4/2003 12595 CITY SPRING LAKE PARK - PARK & REC A-10 6000.00 2/27/2003 4/4/2003 I 12596 TERRY KNaPIK A-2 I 1240.00 I 3/27/2003 4/14/2003 12613 CITY OF SPRING LAKE PARK A-8 I 4077.631 3/27/2003 4/14/2003 12614 CITY OF FRIDL Y A-8 79.21 I 3/27/2003 4/14/2003 12626 CITY OF STPAUL A-8 158.33 4/24/2003 4/28/2003 12634 BOY SCOUT TROOP 174 A-7M X 40.00 *NOTE: Check the TRC column if the expenditure is from the Tax Refund Total Schedule C Lawful Purpose Expenditures I and Credit' (TRC) amount. Your organization may not expend money from for this month. ~ this amount for lawful purposes A-B, A-9, and A-12 or for allowable expenses. Enteron line 41 of Schedule G-1 Schedule D: Board - Approved Expenditures Current Monthly I Board 1 Membershio Date of Check B Aporoved Approval Date Check Number Check made out to: TRCS Code Amount Date I Board-Aooroved Exoenditures for Recreational. Community. & B3-A 7 I I Athletic Facilities Intended Primarily for Persons Under Age 21 M F I Total sche.dule D Baard-Aooroved Expenditures. ~ - Signatures I I I Enter on Ime 42 of Schedule G 1 / declare that all information on this summary and tax retum is true, correct, and complete. Signature of chief executive officer Date '-'------'000-'.-1 I I I \ I I I I ! I i Signature of gambling manager Date I' Mail To: Gamblinq Control Board I Suite 300 South " ! 1711 West County Road B I Roseville, MN 55113 I If you use a TTY, you can call the Board by usinq the Minnesota Relay Service at 1-800-627-3529 and ask to place a call to (612)639-4000. This form will be made availab/e in altemative format (i.e. larae I print, Braille) upon reauest. The information on this form will be used by the Gamblinq Control Board ! to determine your compliance with statutes and rules qoveminq /awful qamblinq activities. All I information supplied by you on this form will become public when received by the Board. (Rev. 11101) Minnesota Gambler