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line 1. Enter the amount from Column F, Line 10,

-B

PERATOR

ULTIPLE

ENEFICIARY

ERMITTEE

Total Net Proceeds, on Page 1, line 5.

CTIVITY

EPORT

AO, P

CHEDULE

AGE

AIR

ARKET

ALUE

ONATED

RIZES

-B

/MBP

PERATOR

ULTIPLE

ENEFICIARY

WARDED BY THE

PERATOR

(

) I

BO, P

ERMITTEE

MBP

NFORMATION

CHEDULE

AGE

If your organization used an operator or was a

Enter the values of donated prizes from Schedule

member of an MBP during any part of the year, enter

B-1, line 9, of the Operator Annual Report (or MBP

the operator/MBP information in the spaces

Annual Report) in Columns A and B.

provided. If more than one operator was used during

the year, or if you were a member of more than one

The value of donated prizes does not reduce the net

MBP, use a separate form to report gaming

proceeds from the gaming activity. It is, however, a

information received from each entity.

part of the total prize limitation for bingo, pull-

tabs and all other games.

Total Gross Receipts, Expenses and Net Proceeds

Generated

the

Operator

Multiple-

More Than One Operator Used: Prepare a separate

Beneficiary Permittee (MBP).

Use the Annual

Schedule BO for each operator used during the year.

Report generated by your organization's operator or

MBP to complete this schedule.

Multiple-Beneficiary Permittee Member. Prepare

Schedule BO with the information provided by the

More Than One Operator Used: Prepare a separate

MBP. If your organization was a member of more

Schedule AO for each operator used and enter the

than one MBP, prepare a separate Schedule BO your

sum of the total gross receipts (Column A, line 10)

share of the activity of each MBP.

for all operators on Page 1, line 1 of this report.

Enter the sum of the net proceeds (Column

ERMITTEE

CTIVITY

EPORT

line 10) for all operators on Page 1, line 5.

AP, P

CHEDULE

AGE

Multiple-Beneficiary Permitee Member:

Prepare

This schedule reports gaming activities your

Schedule AO with the information provided by the

organization conducted on its own behalf.

All

member in charge of gaming for the MBP. If your

receipts and expenses related to gaming activities are

organization was a member of more than one MBP

required to be deposited to and disbursed from a

during the year, prepare a separate Schedule AO for

separate gaming account.

your share of the activity of each MBP. Enter the

sum of the net proceeds (Column F, line 10) for all

Pull-Tab Sales by Vendors. Vendor sales of pull-

MBPs on Page 1, line 5.

tabs are reported on Schedule AV and carried

forward to Schedule A. See separate instructions for

Columns A through F: This information is found

Schedule AV.

on Schedule A of the Annual Report provided to

your organization by the operator or MBP. Enter the

Instructions for worksheets to accumulate deposits

amounts from the operator report or MBP report on

and expenses can be found in the instructions for the

this form.

Quarterly Report. If your organization maintains a

general ledger, the information required for this

Column E, Game-Related Expenses.

Enter only

report will be summarized there.

the total expense for each activity from Schedule A

provided by the operator or MBP. Do not prepare a

Column A, Total Gross Receipts. Enter the total

separate Schedule C to report the detail of game-

receipts for each gaming activity in Column A.

related expenses for operator- or MBP-conducted

Enter the sum of the receipts from all activities on

gaming.

line 10 and on Page 1, line 2.

Line 10, Columns A and F. Enter the amount from

Total Gross Receipts when sales tax is imposed by

Column A, line 10, Total Gross Receipts, on Page 1,

the municipality:

Sales tax collected is not

considered part of the sales price of a gaming device,

04-833 (Revised 11/97) Instructions

Page 3 of 10

Form 04-833 - Instructions For Annual Financial Statement - Alaska Department Of Revenue Page 4

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