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<br />.10 <br /> <br />MINNESOTA DEPARTMENT OF REVENUE <br />.LAWFUL GAMBlING ACTIVITY <br /> <br />--_',~---------.---.- <br />! <br />I, <br />I <br /> <br />G-1 SCHEDULE A <br />RECEIPTS and EXPENSES PER PREMISE <br /> <br />Organ. License Premise Number Premise Name <br />03800. .' 012 Wise Guys Pizza I Pub <br />Lines 1-10 and 18-36 correspond t~ Form G-l <br /> <br />(A) <br /> <br />1 81 ngo . . . . . . . .'. . . . . . . . 1 <br /> <br />2 Raffles [ ] Exempt, Schedule-ER . . . 2 <br />3 Paddlet ickets . . . . . . . . .. . . . . 3 <br />4 SUB-TOTAL (Add Lines 1 through 3). . . . . 4 <br />5 Proportional Part, Last Month &-1 Line 6C. 5 <br />6 Adjusted Sub-Total (Line 4 minus Line 5) . 6 <br />7 Income from Interest and Dividends . 7 <br />8 IipboarcJs. . . . . . . . . . . . 8 <br />9 Pu lltabs . . . . '.. . . . . . . 9 <br />10 TOTALS (Add U"es 6 - 9) .10 <br /> <br />Gross (B) <br />0.00 <br />0.00 <br />.1,050.00 <br />1,050.00 <br />0.00 <br />1,050.00 <br />2.97 <br />0.00 <br />16,093.50 <br />17,146.47 <br /> <br />Report Month/year <br />FEBRUARY 2003 <br /> <br />Prizes (C)- <br />0.00 <br />0.00 <br />I,QI5.00 <br />1,015.00 <br /> <br />1,015.00 <br /> <br />0.00 <br />12,747.00 <br />13,762.00 <br /> <br />18 Beginning Inventory (Last Month Line 21) . . . . . . . . . . . 18 <br />19 Gambling Product Obtained, with Sales Tax. . . . . .. -...... 19 <br />20 Goods Available (Line 18 plus Line 19) .. . . . . . . . 20 <br />21 Ending Inventory (excludes Sales Tax). . . . . . . . . . .. . 21 <br />~2 Goods Used (Une 20 minus Line 21) . . . . . . . . . . . 22 <br />23 Compensation and Payroll ta~s . . . . . . . . . . . . .. . . .23 <br />24 Penalty or Interest on Taxes paid during the month . . . . . . 24 <br /> <br />25 Advert 1 s 1-og . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 <br /> <br />---~1- :;~~~2J~::e:n:n~~:r ~c:ffI~;:~j . siipph~s .'I~ E~p~n~e; :.. -:..:-: -: -..:.. -:- -:- -~ -~ i~ .. <br /> <br />28 Purchase/Repair of Furnishings or Devices for Gambling . . . 28 <br />29 Rent for the Purpose of Conducting Lawful Gambling. . . . . . 29 <br /> <br />30 Ut i 1 it i es. . . . . . . -. . . . . . . . . . . . . . . . . . .. . 30 <br />31 Theft .nd Liability Insurance. ~ . . . . . . . . . . . . . . . . . 31 <br />32 Manager's Bond, licenses, Local Fee, Premises Permit. . 32 <br />33 Cash Long(-) or Cash Short(+). . . . . . . . . . . . . . 33 <br />34 DEPOSIT REQUIRED,. Excess Cash Short Reimbursement(-) . . . . 34 <br />35 Deposited Amount, Excess Expense Reimbursement(-). . . . . . 35 <br />36 TOTAL ALLOWABLE EXPENSES (Add Lines 22 through 35) . . . . . . . 36 <br /> <br />Line numbers correspond to the Tax Return (Form G-1) line numbers. <br /> <br />Gss 7/99 <br /> <br />Het <br />0.00 <br />0.00 <br />35.00 <br />35.00 <br />0.00 <br />35.00 <br />2.97 <br />0.00 <br />3,346.50 <br />3,384.47 <br /> <br />. i <br />Ii <br /> <br />513.34 <br />295.83 <br />809.17 <br />418.50 <br />390.67 <br />2,688.07 <br />0.00 <br />0.00 .- U <br />66.25 d <br />79:43 -- 'd' :j <br />0.00 ,I <br />100.00 II <br />0.00 !I <br />0.00 ii <br />0.00 <br />96.50 <br />0.00 <br />0.00 <br />3,420.92 <br />