Schedule B2 - Lawful Gambling Report Of Barcoded Games

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B2
Schedule B2 — Lawful Gambling Report of Barcoded Games
Use this schedule to to report paper pull-tab, tipboard, paddleticket, and raffle board games removed from play during the month. If you’re reporting
destroyed, fund loss, defective or missing games, read the Lawful Gambling Tax instructions booklet. Complete a separate
Federal ID Number (FEIN)
Minnesota Tax ID
Schedule B2 for each type of game and operation.
Name of Gambling Site
License Number
Site Permit Number
Month/Year Reported
Page
of
Type of Operation (check one):
Booth
Bar-op
Pull-tab Dispenser
Game Status (Check One):
Type of Game
Raffle Boards
Paper Pull-tabs
Paddletickets
Played
Missing
Reported as
Destroyed with
Fund Loss Games
(Check One):
Tipboards
Progressive Tipboards
Progressive Pull-tabs
Defective
Fund Loss
Revenue Approval
Destroyed by Revenue
A
B
C
D
E
F
G
H
I
J
K
L
M
Mfg
Part Number
Game
Date
Ideal
Ideal Prizes
Value of
Gross Receipts
Value of
Net Receipts
Cash-in-Hand
Cash Long/(Short)
Date Game
ID
Serial Number
in Play
Gross Receipts
Unsold Tickets
(E Minus G)
Prizes Paid
(H minus I)
(K Minus J)
Removed
Totals from previous page, if any
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16 Total
Enter the totals from Columns H, I and J for each type of game on the appropriate lines of Form G1. Attach this schedule to your Form G1.
(Rev. 12/15)

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