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MINNESOTA DEPARTMENT OF REVENUE <br />Sales and Use Tax <br />MN ID•: 7756699 Period End: <br />Date Filed. - <br />COUNTRY LOUNGE INC Amend: <br />3590 HOFFMAN RD E <br />SAINT PAUL MN 551105375 Amend Date: <br />Filing Sunimary (all locations): <br />Gross Receipts: $10,384 <br />Page 1 <br />Sep-30-2012 <br />Nov-01-2012 <br />Tax Line 9 <br />Tax Line Description <br />Taxable Units <br />Rate <br />Tax Due <br />100 <br />General Rate Sales Tax <br />$9,098 <br />6.875% <br />$625 <br />111 <br />Liquor Gross Receipts Sales <br />$6,526 <br />2.5% <br />$163 <br />112 <br />Liquor Gross Receipts Use <br />$646 <br />2.5% <br />$16 <br />200 <br />Use Tax Purchases <br />$646 <br />6.875% <br />$44 <br />210 <br />Variable Rate Purchases <br />$0 <br />Varies <br />$0 <br />440 <br />Transit Improvement Sales <br />$9,098 <br />025% <br />$23 <br />441 <br />Transit Improvement Use <br />$46 <br />0.25% <br />$0 <br />Total Tax <br />$871 <br />See the following page(s) for detail by location. <br />