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2004-07-14 CC WS & Meeting
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2004-07-14 CC WS & Meeting
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<br />MINNESOTA LAWFUL GAMBLING <br />LGIOIO SCHEDULE C/D <br /> <br />1/ Z 2) D / r GAMBLING CONTROL BOARD <br />Lawful Pmpose & Board Approved Expenditures <br /> <br />City <br />Forest Lake <br />Page <br />1 of 1 <br /> <br />License Number <br />03800 <br />Amended CfD? <br />No <br /> <br />Organization Name <br />. Dead Broke Saddle Club <br />Month and Year <br />Anril 2002 <br /> <br />Schedule C: Lawful Purpose Expenditures <br /> <br />Date arg. Check Check Check <br />Approved Date Number Made out to <br /> <br />A A-7 <br />mc Code MIF <br /> <br />Amount <br /> <br />03/2612002 04lll/2002 6474 Centerville E1ementaIy <br />PnIpose: Donation For Computers <br /> <br />a(l) <br /> <br />5000.00 <br /> <br />'1'1' r-;f:PZ-- <br /> <br />, <br /> <br />Total all Schedule C items $ <br />To line 41 ofFormG-1 <br /> <br />5000.00 <br /> <br />Schedule D: Board Approved Expenditures <br /> <br />Date Org. Check Check Check <br />Approved Date Number Made out to <br /> <br />Date Board <br />Approved <br /> <br />B A-7 <br />TRC Code MIF <br /> <br />Amount <br /> <br />NONE THIS MONTH <br /> <br />For fucilities -intended urimarilv fur nersons under 21: <br /> <br />Total all Schedule D items $ <br />To line 42 ofFonn 6-1 <br /> <br />Signatures <br /> <br />I declare that this Schedule C/D is correct and complete to the best of my knowledge and belief. <br />SigDatme Date <br />Chief Executive <br /> <br />Signature <br />Gambling Manager <br />Mail to: Suite 300 South <br />1711 West County Road B <br />Roseville, MN 55113 <br /> <br />Dote <br /> <br />0" OS/03 <br /> <br />~ <br />
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