Form G74 - Distributor Monthly Pull-Tab And Tipboard Tax Return

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G74
Distributor Monthly Pull-Tab and Tipboard Tax Return
File your return by the 20th day of the following month and pay the tax due by the last day of the following month.
In addition, you must electronically file your monthly sales report by the 20th day of the following month. The sales report must
include all sales and credits of gambling products and gambling equipment for bingo paper, paddletickets, pull-tabs, raffles and
tipboards, which occurred during the month.
Check if amended:
Distributor name
FEIN or Social Security number
License number
Address
Minnesota tax ID number
City
State
Zip code
Month/year of this return
1 Total ideal gross receipts from tipboard and pull-tab games
sold to licensed organizations during the month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Total dollar amount for credit memos issued . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3 Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Multiply line 3 by 1.7% (.017) and PAY THIS AMOUNT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
To pay, log in at or call 1-800-570-3329 to pay by phone. (You are required to
pay electronically if your tax liability was $10,000 or more during the last 12 months ending June 30.)
I declare that all information on this tax return is true, correct and complete.
Signature of officer, partner or proprietor
Title
Daytime phone
Date
Mail to: Minnesota Revenue, Mail Station 3350, St. Paul, MN 55146-3350.
; lawfulgambling.taxes@state.mn.us; 651-297-1772 (TTY: Call 711 for Minnesota Relay)
(Rev. 6/11)

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