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~or~sheeC for ~5-~5 and ~5-55 Expense Calculations <br /> <br /> ** Effective Jul7 1988 ** <br /> <br />Organization Name ~m<~? ~Io,~_~CL~ License No~. A-o{lzoB <br />Month ~P~ ~.ar_ ~%~, . Worksh..c No. ~ <br /> (First worksheet is No. 1, second <br /> worksheet is No. 2, etc.) <br /> <br />A. Line 13C Per Tax Return (CGO0011-Ot) <br /> <br />B. Item A x .15 <br /> <br />C. Line IC Per Tax Return x .10 <br /> <br />D. Total of Items B and C <br /> (Maximum allowable expense) <br /> <br />E. Total from Line 35 Per Tax Return <br /> <br />F. Difference Between Allowable Expenses <br /> and Actual Expenses (D - E) <br /> (If E is greater than D, enter as a <br /> negative amount on F) <br /> <br />G. Total-to-date from Last Worksheet <br /> <br />H. Total-to-date (F + G) <br /> <br />c. O <br /> <br />If Total-to-date balance is negative, your organization must <br />reduce its expenses to meet the expense limits for the year. <br /> <br />Worksheets must be completed for the organization as a whole. <br />total-to-date is always carried forward. <br /> <br />The <br /> <br />DO NOT SUBMIT THIS FORM WITH THE MONTHLY TAX RETURN - Submit the completed <br />form to the Gamins Division with your license renewal and/or application <br />for an additional site· <br /> <br />Department of Revenue - Gaming Division <br />Mail Station 3315 <br />St. Paul, MN 55146-3315 <br /> <br />F61d(2/14/89) <br /> <br /> <br />