Laserfiche WebLink
r <br /> MINNESOTA DEPARTMENT OF REVENUE <br /> Mail Station 3350 LAWFUL GAMBLING ACTIVITY SUMMARY and TAX RETURN <br /> St.Paul, MN 55146 - 3350 License: 03800 Month: MARCH 1999 <br /> Premises: 3 Schedule B2 GAME COUNT: 79 <br /> Organization Name: Address: <br /> Dead Broke Saddle Club 19680 Harrow Avenue North, Forest Lake MN 55025 <br /> ttached: Schedule A: 3, Schedule 82: 7, Schedule E: 1. Schedule F: 1 <br /> (A) Gross (B) Prizes (C) Net <br /> 1 Bingo 0.00 0.00 0.00 <br /> 2 Raffles 0.00 0.00 0.00 <br /> 3 Paddletickets 600.00 580.00 20.00 <br /> 4 Income from Interest and Dividends 73.89 - -- 73.89 <br /> 5 SUB -TOTAL (Add Lines 1 through 4) 673.89 580.00 93.89 <br /> 6 Last Month Line 7C, if it was negative . . 0.00 - -- 0.00 <br /> 7 Adjusted Sub -Total (Line 5 minus Line 6) . 673.89 580.00 93.89 <br /> 8 Tipboards 0.00 0.00 0.00 <br /> 9 Pulltabs 215,709.50 173,176.00 42,533.50 <br /> 10 TOTALS (Add Lines 7,8,9) 216,383.39 173,756.00 42,627.39 <br /> 11 Gambling Tax (9.5% of Line 7C) 8.92 <br /> 12 Combined Receipts Tax (Schedule E, Line 9) 12,299.65 <br /> 13 PAY THIS AMOUNT (Line 11 plus Line 12) Check to Department of Revenue: 12,308.57 <br /> 14 Gambling Tax Paid to Distributors for Pulltabs & Tipboards 4,524.95 <br /> 15 TOTAL Gambling Tax (Add Lines I3 and 14) 16,833.52 <br /> 16 GROSS PROFIT, After Taxes (Line IOC minus Line 15) 25,793.87 <br /> 17 25,793.87 <br /> 18 Beginning Inventory (Last Month Line 21) . . 3,689.76 <br /> 19 Gambling Product Obtained, with Sales Tax. . 3,137.46 <br /> 20 Goods Available (Line 18 plus Line 19) . . . 6,827.22 <br /> 21 Ending Inventory (excludes Sales Tax). . . . 3,711.92 <br /> 22 Goods Used (Line 20 minus Line 21) 3,115.30 <br /> 23 Compensation and Payroll taxes 10,976.25 <br /> 24 Penalty or Interest on Taxes paid during the month . . . 0.00 <br /> 5 Advertising 0.00 <br /> 26 Accounting and Legal Services 801.00 <br /> 27 Miscellaneous Expenses, Supplies & Bank Charges 35.53 <br /> 28 Purchase /Repair of Furnishings or Devices for Gambling . 75.00 <br /> 29 Rent for the Purpose of Conducting Lawful Gambling . . . 2,450.00 <br /> 30 Utilities 141.45 <br /> 31 Theft and Liability. Insurance 0.00 <br /> 32 Manager's Bond, Licenses, Local Fee, Premises Permit . . 0.00 <br /> 33 Cash Long( -) or Cash Short( +) 188.00 <br /> 34 DEPOSIT REQUIRED, Excess Cash Short Reimbursement( -) . . 0.00 <br /> 35 Deposited Amount, Excess Expense Reimbursement( -) 0.00 <br /> 36 TOTAL ALLOWABLE EXPENSES (Add Lines 22 through 35) 17,782.53 <br /> 37 NET PROFIT (Line 17 minus Line 36) . . . . . . . . . . 8,011.34 <br /> 38 Prior Month Profit Carry -Over (Line 44 from Last Month) 45,613.84 <br /> 39 Approved Adjustments (Attach Letter and /or Add Line 6C if not zero). . 0.00 <br /> 40 BALANCE Sub -Total (Add Lines 37, 38 and 39) 53,625.18 <br /> 41 Lawful Purpose Expenditures (Line 11 Schedule C /D) . . . . 139.00 <br /> 42 Board - Approved Expenditures (Line 13 Schedule C /D) . . . . 0.00 <br /> 43 Total Expenditures (Add Lines 41 and 42) 139.00 <br /> 44 PROFIT CARRY -OVER (Line 40 minus Line 43) 53,486.18 <br /> 46 FUNDS BALANCE DIFFERENCE from Schedule F, Line 22 0.00 <br /> 47 Pulltab & Tioboard UNSOLD TICKETs this month 40,232.00 <br /> I declare that all information on this summary and return is true, correct and complete. <br /> Chief Executive r - / Date Gambling <br /> Officer: /j, - Manager: t / /y jJ <br /> � y i9 -99 <br /> repared By Date 612/464 -7225 <br /> t k t i . CPi4 109/95 <br />