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<br />MINNESOTA LAWFUL GAMBLING <br />LGIOIO SCHEDULE CID <br /> <br />Organization Name <br />Dead Broke Saddle Club <br />Month and Year <br />February 2005 <br /> <br />Schedule C: Lawful Purpose Expenditures <br /> <br />Date Org. Check Check Check <br />Approved Date Number Made out to <br /> <br />2/22/2005 2/22/2005 8643 Tsunami Relief <br /> <br />Mail to: Suite 300 South <br />1711 West County Road B <br />Roseville, MN 55113 <br /> <br />GAMBLING CONTROL BOARD <br />Lawful Purpose & Board Approved Expenditures <br /> <br />License Number <br />03800 <br />Amended C/D? <br />No <br /> <br />City <br />Forest Lake <br />Page <br />2 of 2 <br /> <br />A A-7 <br />TRC Code M/F <br /> <br />a(2) <br /> <br />Purpose: Donation <br /> <br />Signatures and Schedule-C/D totals on page 1. <br /> <br />4g <br /> <br />Amount <br /> <br />500.00 <br /> <br />Gss 11104 <br />