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<br />MINNESOTA DEPARTMENT OF REVENUE <br />LAWFUL GAMBLING ACTIVITY <br /> <br />Organ.License Premise Number Premise Name <br />03800 008 The Trio Inn <br />Lines 1-10 and 18-36 correspond to Form'G-1 <br /> <br />1 Bingo. · · . . . . . . . . . . . .. . 1 <br /> <br />2 Raffles [ ] Exempt, Schedule-ER . . . . . 2 <br />3 Paddletickets . . . . . . . . . .. . 3 <br />4 SUB-TOTAL (Add Lines 1 through 3). . . . . 4 <br />5 Proportional Part, Last Month G-l Line 6e. 5 <br />6 Adjusted Sub-Total (Line 4 minu~ Line 5) . 6 <br />7 Income from Interest and Dividends . . . . 1 <br />8 Tipboards. . · . . . . . . . . . 8 <br />9 Pulltabs . . . . . . . . . . . . .. . 9 <br />10 TOTALS (Add Lines 6 - 9) . . . . . .10 <br /> <br />G-I SCHEDULE A <br />RECEIPTS and EXPENSES PER PREMISE <br />Report Month/Year <br />MARCH 2003 <br /> <br />(A) Gross (B) 'Prizes (C) <br />0.00 0.00 <br />0.00 0.00 <br />1,920.00 1,856.00 <br />1,920.00 1,856.00 <br />0.00 <br />1,920.00 <br />2.46 <br />0.00 <br />59,291.00 <br />61,213.46 <br /> <br />18 Beginning Inventory (Last Month line 21) . <br />19 Gambling Product Obtained, with Sales Tax. . . . . . . <br />20 Goods Available (line 18 plus Line 19) . . <br />21 Ending Inventory (excludes Sales Tax). . . . . . . . <br />22 Goods Used (Line 20 minus Line 21) . . . . . . . . . . <br />23 Compensation and Payroll taxes. . . . . . . . . . . . . . <br />24 Penalty or Interest on Taxes paid during the month. . . . <br /> <br />25 Advertising. . . . . . . . . . . . . . . . . . . . . . . . <br /> <br />26 Accounting and Legal Services. . . . . . . . . . . . <br />27 Bank Charges and Miscellaneous Supplies & Expenses. . <br />28 Purchase/Repair of Furnishings or Devices for Gambling <br />29 Rent for the Purpose of Conducting Lawful Gambling. <br />30 Utilities. . . . . . . . . . . . . . . . . . . . . . <br />31 Theft and l iabi 1 ity. Insurance. . . . . . . . . . . . <br />32 Manager's Bond, Licenses, local Fee, Premises Permit <br />33 Cash long( -) or Cash Short( +). . . . . . . . . . . . <br />34 DEPOSIT REQUIRED, Excess Cash Short Reimbursement(-) . <br />35 Deposited Amount, Excess Expense Reimbursement(-). . <br />36 TOTAL ALLOWABLE EXPENSES (Add Lines 22 through 35) . <br /> <br />1,856.00 <br /> <br />0.00 <br />49,793.00 <br />51,649.00 <br /> <br />. . 18 <br />19 <br />20 <br />. 21 <br />22 <br />. . . 23 <br />24 <br />. . . . 25 <br /> <br /> <br />· . . . . . 26 <br /> <br />· · .. 27 <br />. 28 <br />. 29 <br />30 <br /> <br /> <br />. . . . . . 31 <br /> <br />32 <br />33 <br />34 <br />35 <br />36 <br /> <br />Line numbers correspond to the Tax Return (Form G-I) line numbers. <br /> <br />Gss 7/99 <br /> <br />Net <br />0.00 <br />0.00 <br />64.00 <br />64.00 <br />0.00 <br />64.00 <br />2.46 <br />0.00 <br />9,498.00 <br />9,564.46 <br /> <br />985.36 <br />888.82 <br />1,874.18 <br />916.55 <br />957.63 <br />3,041.51 <br />0.00 <br />0.00 <br />53.00 <br />0.00 <br />0.00 <br />400.00 <br />0.00 <br />0.00 <br />0.00 <br />87.00 <br />0.00 <br />0.00 <br />4,539.14 <br />