Form 04-833 - Games Of Chance And Contests Of Skill Permittee Annual Financial Statement - 1998
Download a blank fillable Form 04-833 - Games Of Chance And Contests Of Skill Permittee Annual Financial Statement - 1998 in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 04-833 - Games Of Chance And Contests Of Skill Permittee Annual Financial Statement - 1998 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5
6
7
8
9Dept Use Only
Alaska Department of Revenue
State of Alaska
Income and Excise Audit Division
Games of Chance and Contests of Skill
FSN
PO Box 110420
Juneau, AK 99811-0420
1998 Permittee Annual Financial Statement
Telephone (907) 465-2320
AS 05.15.080(b)
Due Date: March 15, 1999
Fax (907) 465-3098
Federal EIN
Permit Number
Organization Name
Telephone Number
Mailing Address
Fax Number
City
State
Zip Code
E-mail Address
CALCULATION OF ADDITIONAL FEE
1.
Gross receipts from operator/MBP activity report (Schedule AO, column A, line 10)…………… 1
2.
Gross receipts from permittee activity report (Schedule AP, column A, line 10)………………… 2
3.
Gross receipts from vendor activity report (Schedule AV, column A, line 6)……………………… 3
4.
Total gross receipts from all activities (add lines 1, 2, and 3)………………………………………………………………………… 4
5.
Net proceeds from operator/MBP activity report (Schedule AO, column F, line 10)……………… 5
6.
Net proceeds from permittee activity report (Schedule AP, column F, line 10)…………………… 6
7.
Net proceeds from vendor activity report (Schedule AV, column I, line 6)………………………… 7
8.
Total net proceeds from all activities (add lines 5, 6, and 7)………………………………………………………………………… 8
If total gross receipts on line 4 are less than $20,000, stop here and go to line 13. NO FEE IS DUE.
9.
ADDITIONAL FEE: Multiply line 8 by 1% …………………………….……………………………………………………………… 9
10.
Penalty for late payment (1% per 30 day period or fraction of a period, not to exceed 25%)……………………………………… 10
11.
Interest (12% annually)…………………………………………………………………………………………………………………. 11
Amount you owe
12.
Total amount due (add lines 9, 10, and 11)…………………………………………………………………………………………… 12
GAMING ACCOUNT BALANCE
13.
Prior year balance of Games of Chance and Skill checking account………………………………13
14.
Deposits (Schedule F, line 5)………………………………………………………………………… 14
15.
Total net proceeds available for disbursement (add line 13 and line 14)…………………………………………………………… 15
16.
Interest earned on Games of Chance and Skill checking account……………………………………………………………………16
17.
Total donation of net proceeds (Schedule E)………………………………………………………… 17
18.
Other adjustments (Schedule F-1, line 6)…………………………………………………………… 18
19.
Total reductions to checking account (add line 17 and line 18)……………………………………………………………………… 19
20.
Year-end balance of Games of Chance and Skill checking account (add lines 15 and 16, subtract line 19)…………………… 20
We declare under penalty of unsworn falsification, that we have examined this report, including accompanying schedules and statements, and to the best of
our knowledge and belief, it is true and complete.
Member in Charge
Printed Name
Date
X
President or Treasurer
Printed Name
Date
X
Paid Preparer's Signature
Printed Name
Date
X
Firm Name
Firm Address
DEPARTMENT USE ONLY
VALIDATION
PMD:
Attach a copy of your December 31, 1997 and December 31, 1998 bank statements and bank reconciliations.
Form 04-833 (Revised 11/98)
Page 1
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial