Laserfiche WebLink
<br />MINNESOTA DEPARTMENT OF REVENUE <br /> <br />MONTHLY SUlt4ARY and TAX RETURN (6-1) <br />Lawful Gambling Activity <br /> <br />rganization License <br />03800 <br />Name <br />Dead Broke Saddle Club <br />Schedule B-2 Game Count <br />139 <br /> <br />Month and Year Premises <br />JUNE 2002 5 <br />Address <br />19680 Harrow Avenue North. Forest Lake MN 55025 <br />Attached: Schedule A Schedule B2 Schedule F <br />5111 <br /> <br />1 Bingo. <br /> <br />(A) Gross (B) Prizes (C) Net <br />1 0.00 0.00 0.00 <br /> <br />2 Raffles [ ] Exempt, Schedule-ER <br />3 Paddletickets. . . . <br /> <br />4 SUB-TOTAl (Add Lines 1 through 3). <br /> <br />5 Last Month Line 6C, if it was negative <br /> <br />6 Adjusted Sub-Total (Line 4 minus Line 5) 6 <br /> <br />7 Income from Interest and Dividends <br /> <br />7 <br />8 <br />9 <br />.10 <br /> <br />8 Tipboards. <br />9 Pulltabs . <br /> <br />10 TOTALS (Add Lines 6,7,8,9) <br /> <br />11 Gambling Tax (8.5% of Line 6C) <br /> <br />12 Combined Receipts Tax (Schedule E, Line 9) <br /> <br />2 <br />3 <br />4 <br />5 <br /> <br />0.00 <br />1,470.00 <br /> <br />0.00 <br />1,421.00 <br />1,421.00 <br /> <br />1,421.00 <br /> <br />0.00 <br />207,967.00 <br />209,388.00 <br /> <br />0.00 <br />49.00 <br />49.00 <br />0.00 <br />49.00 <br />31. 75 <br />0.00 <br />46,908.00 <br />46,988.75 <br /> <br />11 <br /> <br />4.17 <br /> <br />1,470.00 <br /> <br />0.00 <br />1,470.00 <br />31. 75 <br />0.00 <br />254,875.00 <br />256,376.75 <br /> <br />12 13,000.24 <br /> <br />13 PAY THIS AMOUNT (Line 11 plus Line 12) Check to Department of Revenue. 13 13,004.41 <br /> <br />14 Gambling Tax Paid to Distributors for Pulltabs & Tipboards <br />15 TOTAL Gambling Tax (Add Lines 13 and 14) . . . <br /> <br />8,231. 54 <br /> <br />14 <br /> <br />15 21,235.95 <br /> <br />16 GROSS PROFIT, After Taxes (Line 10C minus Line 15) to line 17, page 2. 16 25,752.80 <br /> <br />correct and co lete. <br />/' Date <br />~ 7-Z6> 0<- <br /> <br />I dec lare tha <br />Signature <br />Chief Exec <br />Signature <br />Pre arer <br />Mail to: MN D <br /> <br /> <br />L___ __n <br />