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<br />MINNESOTA JlEPARTIIENT . OF REVENUE <br />~. (.BlJNG ~IYI1Y <br /> <br />Wgan~license Premise NUmber Premise Name <br />. 03800 . 008 The Trio Inn <br />Lines 1-10 an4 18-36 correspond to Form &-1 <br /> <br />G-l SCHEDUlE A <br />RECEIPTS. and EXPENSES Pal PREMISE <br />R-eport Month/year <br />~y 2003 <br /> <br />(A) <br /> <br />1 Bingo. . . . . .. . . . . . . . . . . . . . 1 <br />2 Raffles [ ] Exempt, Schedule-ER . . . . . 2 <br />3 Padd1etickets . . . . . . . . . . . . . . 3 <br />4 SUB~TOTAL (Add Lines 1 through 3)~ . . . . 4 <br />5 Proportional Patt, last Month G-l Line 6C. 5 <br />6 Adj~sted Sub-Tot~l (Line 4 minus Line 5) . 6 <br />7 Income from Inter~st and Dividends . . . . 7 <br />.8 Tipboards. '. . . . . . . . . . . . . . 8 <br />9 Pul1tabs . . . .'. . . . . . . . . . . . . 9 <br />10 TOTALS (Add Lines 6 - 9) . . . . . . . . .10 <br /> <br />Gross (B) Prizes ee) Net <br />. 0.00 .0.00 0.00 <br />0.00 a.oo 0.00 <br />2,340.00 2,262.00 78.00 <br />2,340.00 2,262.00 78.00 <br />0.00 0.00 <br />2.340.00 2,262.00 78.00 <br />4.30 4.30 <br />0.00 0.00 0.00 <br />31,919.QO 25,687.00 6,232.00 <br />34,263.30 27,949.00 6,314.30 <br /> <br />18 Beginning Inventory (Last Montb Line 21) . . . . . . . 18 <br />19 Gambling Product Obtai~, with Sales Tax. . . . . . . . . . . . . . . 19 <br />20 Goods Avaf1ab1~ (Line 18 plus Line 19) . . . . . . . . . . . . . . 20 <br />21 Ending Inventory (excludes Sales Tax).. . . . . . . . . . . . 21 <br />22 Goods Used (Line 20 mfnus Line 21) . . . . . . . . . . . . . . . . . . 22 <br />23 Compensation and Payroll taxes . . . . . . . . . . . . . . ... . . 23 <br />~4 Penalty or Interest on Taxes paid during the month . . . . . . . . 24 <br /> <br />25 Advert i ~ 1 ng. . . · . . . . . . . . . . . . . . . . . . . . . . . . . . 25 <br />26 Accounting and L~l Services. . . . . . . . . . . . . . . . . . . . . 26 <br />27 Bank 'Charges and "isce1laneous Supplies I Expenses . . . . . . . . 27 <br />28 PurchasejRepatr of Furnishings or Devices for Gambling . . . . . . . . 28 <br />29 Rent for the Purpose of Conducting Lawful Gambling . . . . . . . . 29 <br /> <br />30 Ut i 11 ties · · . · . . . . . . . . . . .' . . . . . . . . . . . . . . 30. <br /> <br />31 Theft and Liability Insurance. . .. . . . . . '. . '. . . . . . . . . 31 <br />32 Man.ger's Bond, Licenses, Local Fee, Premises Permit. . . . . . . . . 32 <br />33 Cash Long(-) or Cash Short(+). . . . . . . . . . . .. . . . . . . . . . 33 <br />34 DEPOSIT REQUIRED, Excess Cash Short Re1mbursement(-) . . . . . . 34 <br />35 Deposited Amount, Excess Expense Reimbursement(-). . . . . . . 35 <br />36 TOTAL ~LOIIABLE EXPEISEStAddL ioes 22~hroughm35) . . . . . . . . . . 36 <br /> <br />Line numbers correspond to the Tax Return (Form G-l) line numbers. <br /> <br />Gss 7/99 <br /> <br />1,230.58 <br />481.92 <br />1,712.50 <br />1,194.97 <br />517.53 <br />3,176.21 <br />0.00 <br />0.00 <br />66.25 <br />193.77 <br />0.00 <br />800.00 <br />.0.00 <br />0.00 <br />0.00 <br />-7.00 <br />0.00 <br />0.00. <br />. 4~746.76 <br />