G1 P2
Lawful Gambling Monthly Tax Return (continued)
Organization Name
Federal ID Number (FEIN)
Minnesota Tax ID Number
License Number
21 Lawful purpose expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
22 Total lawful purpose expenditures (add lines 20 and 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
23 Allowable expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
24 a Starting cash banks per books . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24a
b Unreimbursed starting cash banks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24b
End-of-month cash balance in starting banks (subtract line 24b from 24a) . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
I declare that all information on this summary and tax return is true, correct and complete.
Chief Executive Officer (print)
Chief Executive Officer Signature
Date
Daytime Phone
Gambling Manager (print)
Gambling Manager Signature
Date
Daytime Phone
Preparer (print)
Name of Firm
Preparer Signature
Date
Daytime Phone
Mail Form G1, schedules and any required attachments to:
Minnesota Revenue, Mail Station 3350, St . Paul, MN 55146-3350