2003-03-12 CC Packet - Laserfiche WebLink

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MiNN"ESOT A Department of Revenue Receipts and Expenses Per Premises G-1 Schedule A OrganIzatIon LIcense Number PremIses permit number PremIsesName 00584 8-00584-01 0 KELLY'S KORNER Month and year reported 1/ 2003 Column A Unes 1-10 correspond to Form G-1. gross receipts 1 Bingo 1 0.00 2 RafIIes 2 0.00 3 Paddletfckets 3 5785.00 4 Add lines 1 through 3 4 5785.00 5 If line 6c of last month's Form G-1 or Schedule A Is negative, list (without parentheses) In columns A and C 5 0.00 6 Subtrad line 5 from line 4 6 5785.00 7 Income from interest and dividends (fill In same amount in columns A and C) 7 .0.00 8 Tipboards 8 0.00 9 Pulltabs 9 39535.00 Column B prizes 0.00 0.00 5426.00 5426.00 Column C net receipts 0.00 0.00 360.00 360.00 5426.00 0.00 360.00 0.00 33354.00 0.00 0.00 6181.00 10 Add lines 6 through 9. Une 10c Is your gross profit for the month 10 45320.00 There are no lines 11-17. Unes 18-36 correspond to Form G-1. 18 Beginning Inventory (from line 21 of last month's Form G-1) 19 Cost of gambling equipment obtained during the month. Onclude sales tax, but do not include the 1.7 percent tax listed on distributor's Invoices) 20 Add lines 18 and 19 21 Ending Inventory (dollar value on the last day of month; do not include sales tax or 1.7 percent tax listed on distributor's Invoices) 22 Total value of the gambling equipment sold (subtrad line 21 from line 20) 23 Compensation and payroll taxes 24 Penalty and Interest you paid on taxes, Including payroll taxes, on any Form G-1 or Schedule C since beginning gambling activities 25 Advertising 26 Accounting services for lawful gambling tax forms, annual audit or review, and qualifying legal work 27 Bank service charges; office supplies; lodging, meals and transportation for lawful gambUng classes conduded by state agencies; and miscellaneous expenses 28 Purchase and/or repair expenses for office furnishings and office equipment used for gambling, and devices used for gambling 29 Rent for conducting lawful gambling 30 Utilities used for conducting lawful gambling 31 Theft insurance and the amount permitted for liability Insurance 32 Local government investigation fee and cost for new or renewed gambling manager's bond, gambling managers license and premise permits 33 Cash long or cash short (If cash long, put parentheses around the amount) 34 Reimbursement for excess cash short (This Is a negative amount) 35 Reimbursement for negative expense calculation (ThIs Is a negative amount) 36 TOTAL ALLOWABLE EXPENSES (add lines 22 through 35) 38779.00 6541.00 &001010 (Rev. 07199) 18 799.84 19 601.78 20 1401.62 21 715.25 22 686.37 23 3687.64 24 0.00 25 0.00 26 0.00 27 840.18 28 0.00 29 1000.00 30 0.00 31 0.00 32 0.00 33 82.00 34 ( 0.00) 35 ( 0.00) 36 6296.19 MInnesola Gambler