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<br />Organization Name License Number <br />Oead Broke Saddle Club 03800 <br />GamblinQ checkinq account <br />1 End-of-month checking account balance from statements <br />2 Deposits made during the month not included in line 1 <br />3 Add lines 1 and 2 . . . . . . . . . . . . . . . <br />4 Checks written during the month not included in line 1. <br />5 RECONCILED BANK BALANCE (line 3 minus line 4) .... <br /> <br />Other funds not included in Checkinq Balance <br />6 Starting banks for games . . 6a 6.800.00 <br />Reimbursment after monthend. 6b 0.00 <br />Monthend cash balance in starting banks. <br /> <br />7 Total ending inventory (G-l line 21) . . <br /> <br />8 Deposit after month-end for Games in G-l <br /> <br />9 Total in Savings & Other funds. . . . <br /> <br />10 Excess shortages (G-l, 34) and prior <br />reimbursement due for excess shortages <br /> <br />19 Add Lines 14 through 18. <br /> <br />GAMBLING FUNDS RECONCILIATION <br />20 GAMBLING FUND BALANCE (line 13 minus 19) . . . . . <br />21 PROFIT CARRY-OVER (from Form G-l line 44). . . . . <br /> <br />22 FUND BALANCE equals PROFIT CARRY-OVER, Difference. <br /> <br />, <br /> <br />MINNESOTA OEPARTMENT OF REVENUE <br />LAWFUL GAMBLING ACTIVITY <br /> <br />11 Fund Loss. (LG-250) . . . . 11a <br />Refund Due (G-7430) . . . _ lIb <br />Open-Game prizes,by check. lIe <br />Prizes bought, not awarded. lId <br />Other additions . . . lIe <br /> <br />12 Add lines 6, 7, 8, 9, 10, 11 . . <br />13 Add lines 5 and 12 . . . . . . . <br /> <br />0.00 <br />,,~1... l~ <br />0.00 <br />0.00 <br />0.00 <br />Tota 1 11 <br /> <br />Unoaid Obliqations and Ooen Game Deoosits <br />14 Tax from G-l line 13 and any <br />prior months taxes. . . . . . <br /> <br />15 Deposits for games still in play <br /> <br />16 Loaned amounts included in bank statement. <br /> <br />17 Product part of unpaid invoices. <br />18 Other subtractions. <br /> <br />Signature 'jjn <br />of Preoarer . '~vJ. <br />Gss 7/99 <br /> <br />\j ;";l,~;,;:~t, <br /> <br />G-1 SCHEDULE F <br />GAMBLING FUND RECONCILIATION <br /> <br />Report Month/Year <br />FEBRUARY 2002 <br /> <br />1 63.884.26 <br />2 5.197.00 <br />3 69.081.26 <br />4 18.685.51 <br />5 50.395.75 <br /> <br />6 6.800.00 <br />7 2.063.93 <br />8 0.00 <br />9 0.00 <br />10 0.00 <br /> <br />.,;~~ '/!. <br />. . . . 12 <br />. . . . 13 <br /> <br />\ b.lD/,; ."'&,1, <br />lut..,~o\ ."If., <br /> <br />14 8.213.14 <br />15 0.00 <br />16 0.00 <br />17 0.00 <br />18 0.00 <br /> 19 8,213.14 <br /> <br />20 <br />21 <br />22 <br /> <br />5~ .,..'l. 'ilL <br />5lS.,'I.'$.'Z1.. <br /> <br />0.00 <br /> <br />D~te <br />l,\'" 0'1..- <br />. <br /> <br />612/464-7225 <br />