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<br />Organization Name <br />Dead Broke Saddle Club <br />Month and Year <br />December 2003 <br /> <br />Schedule C: Lawful Purpose Expenditures <br /> <br />Date Org. Check Check Check <br />Approved Dale Number Made out to <br />12116/2003 12117f2oo3 7991 MNHigh School Rodeo <br />Purpose: 2004 Rodeo Youth <br /> <br />City <br />Forest Lake <br />Page <br />I of I <br /> <br />GAMBLING CONTROL BOARD <br />Lawfull'urpose & Board Approved Expenditnres <br /> <br />license Number <br />03800 <br />Amended CID? <br />No <br /> <br />" MINNESOTA LAWFUL GAMBLING <br />LGIOIO SCHEDULE CID <br /> <br />A A-7 <br />me Code MIF Amoon1 <br />--- <br />a( I) 35000.00 <br /> <br />12116/2003 12117f2003 7992 Toys For Tots <br /> <br />a( 2) <br /> <br />500.00 <br />800.00 <br />475.00 <br />16.00 <br /> <br />, f1)t' ! <br />T .-4>7 <br />tJv <br /> <br />Purpose: Donation <br /> <br />121l6/2003 1211712003 7993 Roland A'llier a( 2) <br />Purpose: ffugo/CenleMlIe Senior Transp <br />12116/2003 12117f2003 '1995 Gambling Control Board a(19) <br />Purpose: License Fees <br />12116/2003 12122f2003 7999 City ofLino Lakes a( 8) <br />Purpose: City Tax <br />1211612003 1213If2oo3 8027 Burlre Wheeler & Assoc a(12) <br />Purpose: Annual Andit <br /> <br />3300.00 <br /> <br />Total all Schedule C items $ <br />To1ine41 ofFo~G-l <br /> <br />40091.00 <br /> <br />Schedule D: Board Approved E:lpenditures <br /> <br />Date Org. Check Check: Check: <br />Approved Date ~ Made outto <br /> <br />Date Board <br />Approved <br /> <br />B A-7 <br />TRC ,Code MIF Amoon1 <br /> <br />NONE THIS MONTH <br /> <br />For facilities intended nrimarilv for nersons under 21: <br /> <br />, <br /> <br />signatures <br /> <br />I declare that lhis Schedule CID is correct and complete to the best of my knowledge and belief. <br />Sigmturo Date <br />Chic:fExecutive <br /> <br />. Total all Schedole D items $ <br />To line 42 ofFOllD G-l <br /> <br />s~ <br />a.mhImgM_ <br />Mail to: Suite 300 Sooth <br />1711 West C<.wtty 1Wod B <br />RmoviIle, MN 55113 <br /> <br />Date <br /> <br />0.. 08/03 <br /> <br />! <br /> <br />~ <br />