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<br />MINNESOTA DEPARTMENT OF REVENUE <br />LAWFUL GAMBLING ACTIVITY <br /> <br />6-1 SCHEDULE A <br />RECEIPTS and EXPENSES PER PREMISE <br /> <br />Organ.license Premise Number Premise Name <br />03800 008 The Trio Inn <br />lines 1-10 and 18-36 correspond to Form G-l <br /> <br />1 Bingo. . . . . . . . . . . . . . . 1 <br />2 Raffles ( J Exempt, Schedule-ER . 2 <br />3 Paddletickets .. . . . . . . . . 3 <br />4 SUB-TOTAl (Add Lines 1 through 3). . . . . 4 <br />5 Proportional Part, last Month G-l Line 6C. 5 <br />6 Adjusted Sub-Total (line 4 minus Line 5) 6 <br />7 Income from Interest and Dividends 7 <br />8 Tipboards. . . . . . . . 8 <br />9 Pulltabs . . . . . . . . . . . . . . 9 <br />10 TOTALS (Add lines 6 - 9) . . . . . .10 <br /> <br />(A) Gross <br />0.00 <br />0.00 <br />1,650.00 <br />1,650.00 <br />0.00 <br />1,650.00 <br />10.10 <br />0.00 <br />45,154.00 <br />46,814.10 <br /> <br />18 Beginning Inventory (last Month line 21) . <br />19 Gambling Product Obtained, with Sales Tax. <br />20 Goods Available (Line 18 plus line 19) . . <br />21 Ending Inventory (excludes Sales Tax). . . <br />22 Goods Used (Line 20 minus line 21) . . . . <br />23 Compensation and Payroll taxes. . . . . . . . . . <br />24 Penalty or Interest on Taxes paid during the month <br />25 Advert i sing. . . . . . . . . . . . . . . . . . . . <br />26 Accounting and legal Services. . . . . . . . . . . <br />27 Bank Charges and Miscellaneous Supplies & Expenses. . <br />28 Purchase/Repair of Furnishings or Devices for Gambling <br />29 Rent for the Purpose of Conducting lawful Gambling. <br />30 Ut il it ies. . . . . . . . . . . . . . . . . . . . . . <br />31 Theft and Liability Insurance. . . . . . . . . . . . <br />32 Manager's Bond, licenses, Local Fee, Premises Permit <br />33 Cash long(-) or Cash Short(+). . . . . . . . . . . . <br />34 DEPOSIT REQUIRED, Excess Cash Short Reimbursement(-) <br />35 Deposited Amount, Excess Expense Reimbursement(-). . <br />36 TOTAL ALLOWABLE EXPENSES (Add Lines 22 through 35) . <br /> <br />Report Month/Year <br />OCTOBER 2002 <br /> <br />(B) Prizes <br />0.00 <br />0.00 <br />1,595.00 <br />1,595.00 <br /> <br />1,595.00 <br /> <br />0.00 <br />37,393.00 <br />38,988.00 <br /> <br />Line numbers correspond to the Tax Return (Form G-l) line numbers. <br /> <br />Gss 7/99 <br /> <br />18 <br />19 <br />20 <br />21 <br />22 <br />23 <br />24 <br />25 <br />26 <br />27 <br />28 <br />29 <br />30 <br />31 <br />32 <br />33 <br />34 <br />35 <br />36 <br /> <br />(C) <br /> <br />Net <br />0.00 <br />0.00 <br />55.00 <br />55.00 <br />0.00 <br />55.00 <br />10.10 <br />0.00 <br />7,761.00 <br />7,826.10 <br /> <br />1,255.31 <br />319.02 <br />1,574.33 <br />966.56 <br />607.77 <br />4,560.36 <br />0.00 <br />0.00 <br />0.00 <br />40.78 <br />0.00 <br />400.00 <br />50.00 <br />0.00 <br />0.00 <br />216.00 <br />0.00 <br />0.00 <br />5,874.91 <br /> <br />, . <br />