Form 04-843 - Operator Quarterly Report - 2002 Page 5
ADVERTISEMENT
1
2
3
4
52002 Operator Quarterly Report
Operator Name / dba
Quarter (check one)
License Number
1st
2nd
3rd
4th
Page _____ of _____
SCHEDULE E: PAYMENTS TO PERMITTEES
PERMITTEE
This form is also available on the Internet
CHECK NO
AMOUNT
Subtotal (amounts from this page) …………………………
TOTAL PAID TO PERMITTEES (include amounts from all pages, should agree with Page 1, Column G, Net Proceeds Paid) …….
Use additional sheets if necessary.
Form 04-843 (Rev 10/01) Page 5
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial