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MINNESOTA DEPARTMENT OF REVENUE <br />Sales and Use Tax Page 1 <br />MN ID: 7756699 Period End: Mar-31-2012 <br />Date Filed: Apr-19-2012 <br />COUNTRY LOUNGE INC Amend: <br />3590 HOFFMAN RD E <br />SAINT PAUL MN 551105375 Amend Date: <br />Filin,t, Summan, (all locations): <br />Gross Receipts: $10,760 <br />Tax Line 4 <br />Tax Line Description <br />Taxable Units <br />Rate <br />Tax Due <br />100 <br />General Rate Sales Tax <br />$9,278 <br />6.875% <br />$638 <br />ill <br />Liquor Gross Receipts Sales <br />$6,700 <br />2.5% <br />$168 <br />112 <br />Liquor Gross Receipts Use <br />$662 <br />2.5% <br />$17 <br />200 <br />Use Tax Purchases <br />$662 <br />6.875% <br />$46 <br />210 <br />Variable Rate Purchases <br />$0 <br />Varies <br />$0 <br />440 <br />Transit Improvement Sales <br />$9,278 <br />0.25% <br />$23 <br />441 <br />Transit Improvement Use <br />$662 <br />0.25% <br />$2 <br />Total Tax <br />$894 <br />See the following page(s) for detail by location. <br />