2003-05-28 CC Packet - Laserfiche WebLink

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MINNESOTA REVENUE SCHEDULE A GAMBLING RECEIPTS and EXPENSES BY SITE [ ] Check here ifthere was no gambling activity during this month at this site. Location Name License Number Site Number MonthlY ear BlackSmith Loun e 03800 00 I A ril 2003 (A) Gross receipts (B) Prizes (C) Net I Bingo. . . . . . . . . . . . . .. .. .. .. .. .. .. .. .. .. .. I 0.00 0.00 0.00 2 Raftles [ ] check if tax exempt, attach Schedule-ER . 2 0.00 0.00 0.00 3 Paddle Tickets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. . 3 1380.00 1334.00 46.00 4 Sub-Total (add lines I through 3). . . . . . . . . .4 1380.00 1334.00 46.00 5 Last month line 6C. if it was negative. . . . 5 0.00 0.00 6 Adjusted Sub-Total (line 4 minus line 5) . . . . . 6 1380.00 1334.00 46.00 7 Interest. dividends and other income. .. .. .. .. .. .. . 7 2.56 2.56 8 Tipboards. . . . . . . .' . . . . .. .. .. .. .. .. . . . 8 0.00 0.00 0.00 9 Pulltabs. . . . . . . . . . . .9 91919.00 75770.00 16149.00 10 Totals (add lines 6. 7.8, 9). .10 93301.56 77104.00 16197.56 (There are no lines 11-17 for this schedule.) 18 Beginning Inventory (last month's line 21). . . . . . . . . . . . 19 Cost of gambling product received with sales tax. . . . . . . . 20 Gambling product available and sales tax (line 18 plus line 19). . 21 Ending inventory (excluding sales tax). . . . . . . . . . . . . . . . . . .18 1556.69 .19 2574.17 .20 4130.86 .. .. .. .. .. .. . .21 2366.16 .. .. .. .. .. .. . .22 1764.70 .23 4197.90 .24 0.00 .25 0.00 . . . .26 53.00 .27 120.25 .28 20.00 .29 1000.00 .30 0.00 .31 0.00 .32 0.00 .33 59.00 .34 0.00 .35 0.00 .36 7214.85 22 Cost of gambling product sold and sales tax (line 20 minus line 21) . 23 Compensation and payroll taxes. . . . . . . . . . 24 Penalty or interest on taxes, paid during the month . 25 Advertising expenses. . . . . . . . . . . . . . . . . . . 26 Accounting and legal services . . . . . . . . . . . . . . . . . 27 Miscellaneous expenses, supplies. bank charges. classes. etc.. . 28 Purchase/repair of furnishings or devices for gambling. 29 Rent for the purpose of conducting gambling. . . . . . . . . . 30 Utilities related to the conduct of gambling. . . . . . . . . 31 Theft and liability insurance. . . . . . . . . . . . . . . . 32 Manager bond, licenses. local government fees, site pennit. 33 Cash Long(-) or Cash Short(+) on games played. . . . . . 34 Deposit required. for excess cash shortage reimbursement . 35 Deposited amount, for excess expense reimbursement . 36 Total allowable expenses (add lines 22 through 35) . . . . Gss 11102