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<br />Ilow <br /> <br />~o <br /> <br />n.t:..'P"'Ift""'a <br /> <br />t:.ha <br /> <br />Mftt'lt:.h1y <br /> <br />CH:y <br /> <br />o~ ...-.~V <br /> <br />10' <br /> <br />o~ ..t: PY"'otr.i~ <br /> <br />"on~~ o~ <br /> <br />19 <br /> <br />L <br /> <br />Site's Net Receipts adjusted for cash differences: <br />Form G-1 Sched. A, Col. 3, line 12 <br />Site's Allowable Expenses: <br />Form G-1 Sched. A, Col. 3, line 35 <br /> <br />$ <br /> <br />2. <br /> <br />3. <br /> <br />Subtract line 2 from Line 1 <br /> <br />$ <br /> <br />4. Monthly federal wagering tax: <br />Form G-1 Sched. C, line 1 <br /> <br />5. Tax paid to distributor: <br />Form G-1 Sched. C, line 18 <br /> <br />6. Combined Receipts: <br />Form G-1 Sched. E, line 6 <br /> <br />7. Site's gross receipts: <br />Form G-1, Sched. A, Column A <br />Sum of lines 4-9 <br /> <br />8. <br /> <br />Divide line 7 by line 6 <br /> <br />% <br /> <br />9. Combined Receipts Tax Paid <br />Form G-1 Sched. E, line 11 <br /> <br />10. Receipts Tax Paid - this site <br />Line 9 times percentage in line 8 <br /> <br />11. <br /> <br />Net Profit CLoss) for the month <br />Line 3 less lines 4 through 10 <br /> <br />$ <br /> <br />Note: A monthly loss may be applied to profits realized within the same permit year <br />by the same site. Net losses may not be carried forward to the next permit year. No <br />refunds will be issued by the City of Ramsey. <br /> <br />12. <br /> <br />Carry-forward Loss (if any) from previous report <br /> <br />-) <br /> <br />13. <br /> <br />Net Profit subject to Ramsey's 10% tax <br />Line 11 plus line 12 <br /> <br />$ <br /> <br />14. <br /> <br />Ramsey's 10% of net profit: <br />Line 13 times 10%, if result is less than zero, <br />Enter "None Due" <br /> <br />$ <br /> <br />Prepared by: <br /> <br />Phone: <br /> <br />Date: <br /> <br />Organization Name: <br /> <br />Site Location: <br /> <br />If you have any questions, please contact the Finance Officer at 427-1410. <br /> <br />City of Ramsey <br />15153 Nowthen Boulevard N.W. <br />Ramsey, Minnesota 55303 <br /> <br />~.:!.. form, your Clh.ok ADd oop.:!... of th. aOZlthl.y r.port. are du. ZlO l.at.r thlLZl <br />th. 20th clay of th. fol.l.ow.:l.Zlg aOZlth. <br /> <br />06/93 <br />