2002-08-28 CC Packet - Laserfiche WebLink

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MINNESOTA Department of Revenue Gambling Fund Reconciliation Attach this schedule to Form G-1 for this month. G-1 Schedule F Organization Name Organization License Number SPRING LAKE PARK LIONS CLUB00584 Month and year reported 7 I 2002 Gambling checking account 1 End-of-the month checking account balance (from bank statements) 2 Deposits made during the month not included on line 1 3 Add lines 1 and 2 4 Checks written during month not included in the amount on line 1 5 Subtract line 4 from line 3 Other gambling funds not included in your checking account. 6 Starting banks per books 6a 26157.00 Unreimbursed losses 6b 0.00 End-of-month cash balance in starting banks for games. (line 6a '6b) 6 7 Ending inventory. (from line 21 oflhis month's Form G-1) 7 8 Cash received but not deposited during the month from sales of games reported on Form G-1. Do not list amounts you included on line 2 8 9 Total savings accounts, certificates of deposit, mutual funds and other negotiable instruments 9 10 Reimbursement for excess cash short. (from line 34 of your Form G-l) 10 11 Fund losses 11a 0.00 Unsold ticket refunds l1b 0.00 Merchandise prizes 11 c 0.00 Merchandise prizes, not awarded 11 d 0.00 Other additions (attach explanation) l1e 0.00 Totai 11 12 Add lines 6 through 11 13 Add line 5 and line 12 Unpaid obligations and receipts from games not closed 14 Tax from any G-1 unpaid at the end oflhis month 14 15 Receipts deposited during the month from games still in play that are not included on Form G-1 15 16 End-of-month amount due to loans made to the gambling fund from any source (inclUde loans from organization's general fund) 16 17 Total cost of games (inciuding the sales tax) unpaid at the end of the month listed on distributor's invoices 17 18 Other subtractions (You must attach a detailed description of each amount included in the total) 18 19 Add lines 14 through 18 Reconciliation 20 Gambling fund balance (subtract line 19 from line 13) 21 Profit carryover (from line 44 of this month's Fonm G-1) 22 If line 20 is more than line 21, subtract line 21 from line 20. Fill in this amount on line 46 of Form G-1 If line 20 is less then line 21, subtract line 20 from line 21. Fill in this amount in parentheses on line 46, Form G-1 1 2 3 4 5 26157.00 8683.04 0.00 0.00 0.00 0.00 12 13 4971.65 0.00 0.00 0.00 0.00 19 20 21 22 154606.13 15133.00 169739.13 35695.97 134043.16 34840.04 168883.20 4971.65 163911.55 163911.88 -0.33 Signature of preparer Name of company if paid preparer Daytime phone Date ---6001D60-(Rev_-o-7199)-----------~---- --------~------Minnesola__Gamb(er_--