Form Cc - Annual Certified Cash Count By Site Page 3
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3Form CC Instructions
All organizations must annually complete
How to file
Note: If the total shortages exceed 0.3 percent, the discrep-
ancies should be investigated. The cash counted for each
and submit a separate Form CC for each
Part 1
game should reconcile to Form LG861, Pull-tab, Game: Site
site to record the certified cash count by
Part 1 must be completed by two individuals of the orga-
Control-Tracking and Auditing.
nization who are not directly involved with the gambling
site.
activities or by an independent CPA.
Part 3
Part 3 may also be completed by a member of the organiza-
All cash must be counted and entered in column D. If there
A certified cash count must be taken for each site on the last
tion who is directly involved with the gambling operation.
are games in play, also complete columns A, B and C.
day of the fiscal year at the close of business, or the first day
of the new fiscal year before the start of business.
Once all games in play have been audited and the cash
Note: Electronic pull-tab games do not need to be audited.
counted, enter the totals into the Start bank reconciliation
Deposit all proceeds from the electronic pull-tabs prior to
The certified cash count must be completed by:
section.
cash count. Count the start bank and record on line 6 of the
• two members, officers or employees of the organiza-
Start Bank Reconciliation (part 3).
Note: Any available start bank for other forms of gambling
tion not directly involved in the organization’s gambling
(e.g., paddlewheel, raffle, bingo, electronic linked bingo and
activities who have been appointed by the organization’s
Part 2 (for pull-tab and/or tipboard games in
electronic pull-tabs banks) and/or back-up banks should be
board; or
play only)
included on line 6 for an accurate start bank total by site.
Part 2 may be completed by a member of the organization
• an independent certified public accountant (CPA).
who is involved with the gambling operation. However, the
Signatures
The individuals who conduct the cash count must sign the
individual(s) who conducts the cash count must observe the
form to certify that the information is correct.
The two individuals or CPA who conducted the cash count
game audit.
must sign the form certifying the information is correct.
Submit the completed Form CC to the chief executive of-
Audit each game in play. It is not necessary to close the
ficer (CEO) or gambling manager as soon as possible after
The individual who completes Parts 2 and 3 does not need
game after being audited.
the close of the organization’s fiscal year. The organization
to sign this form.
has 30 days from its fiscal year end to submit to the Depart-
ment of Revenue the necessary reporting forms, including
Questions?
Form CC for each site.
Website:
Email:
LawfulGambling.Taxes@state.mn.us
Phone: 651-297-1772
weekdays 8 a.m. to 4:30 p.m.
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