Laserfiche WebLink
Minnesota Lawful Gambling <br /> Schedule CID - LG1010 <br /> General Information <br /> orgari¢ationname Nat'l MS Society - MN Chapter License number A -00562 <br /> onth/year reported: O 3 / on , Page 3 of 3 pages Is this an amended Schedule C/D? Y N <br /> iedule C: Lawful Purpose Expenditures Check here if no Schedule C expenditures for this month: 0 <br /> Current Monthly For Code <br /> Membership Date of Check TRCS A A -7 Only _ <br /> Approval Date Check Number Check Made Out To: 1f Code Male Female Amount <br /> 2 -° 19 314-199 41 CITki OF [.via-Ns0 i,i. _A 118'.10 <br /> -23 - 99 3W-199 9 CID OF BRWOKSToN A-O 9s, 34 <br /> 9-aa 9f>' 3f , /q9 4731g r,ORNELI-,K\thLk, gossAis * SHl0 - A - fa - 108.25 <br /> 2 -aa - c c ) 31 4 ,SRGKSONI SENIOR bu ttUG A -08 - /2.-2(-2( 4 2 <br /> A- <br /> A- <br /> A- <br /> A- <br /> A- <br /> A- <br /> February Only Total of all Schedule C Lawful Purpose Expenditures <br /> Enter the amount from line 14 of the Tax Savings Worksheet in the for this month $ <br /> iedule C/D Instruction Booklet $ Enter on line 41 of Monthly Summary & Tax Retum G-1. <br /> schedule D: Board - Approved Expenditures Check here if no Schedule D expenditures for this month D <br /> Current Monthly Date Board <br /> Membership ship of Check TRCS 8 Approva <br /> Approval Date Check Number Check Made Out To: 4 Code Amount Date <br /> B- <br /> B- <br /> B - <br /> Board- Approved Expenditures for Recreational, Community, & 63-A7 <br /> Code <br /> Athletic Facilities Intended Primarily for Persons Under Age 21: <br /> TRCS 4 Male , Female <br /> Total Schedule D Board - Approved Expenditures $ <br /> Signatures Ester on line 42 of Monthly Summary &Tax Return G-1. <br /> I declare that this Schedule CID is correct and complete to the best of my knowledge and belief. <br /> Chief Executive Officer. Date: / / <br /> Gambling Manager. _ Date: / / <br /> Mail to: If you use a TTY, you can call the Board by using the Minnesota Relay Service at 1-800-627-3529 and ask t <br /> Gambling Control Board place a call to (612) 639 -4000. This form will be made available in alternative format (i.e. large print, BraillE <br /> uite 300 South upon request <br /> 11 West County Road B The information requested on this form will become public information when received by the Board, and will b <br /> Roseville, MN 55113 used to determine your compliance with Minnesota statutes and rules governing lawful gambling activities. <br /> ■ 4 <br />