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Monthy Gross Revenue Statistical Report NGC-31 - Nevada
| Monthy Gross Revenue Statistical Report Form. This is a Nevada form and can be used in Tax And License Division Nevada Gaming Commission And State Gaming Contol Board Statewide . |
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NGC-31 (04-24-13) NEVADA GAMING COMMISSION MONTHLY GROSS REVENUE STATISTICAL REPORT Account No., Name, Address, Zip Code Account No.: Legal Name: Trade Name: Address: Zip Code: FILING DEADLINE FOR THIS REPORT: For Gaming operations during the month of: SECTION A CODE 010 011 012 013 014 015 016 017 018 020 021 022 024 053 SLOT MACHINES 1 Cent 5 Cent 10 Cent 25 Cent 50 Cent 1 Dollar Megabucks 5 Dollars 25 Dollars 100 Dollars 500 Dollars Multi Denomination Other Denominations Adjustments NO. OF UNITS COINS IN ($) DROP ($) GROSS REVENUE ($) TOTALS SECTION B CODE TABLE GAMES Craps Roulette Twenty One Wheel of Fortune Mini- Baccarat Baccarat Pai Gow Caribbean Stud Let it Ride Sic - Bo Red Dog Pai Gow Poker 3 - Card Poker Other Games (Describe Below): NO. OF UNITS PIT CREDIT ISSUES ($) PIT CREDIT (CHIPS($)) PIT CREDIT PAYMENT (CASH)($) DROP ($) WIN ($) GROSS REVENUE ($) 002 003 001 005 007 006 037 056 057 039 044 043 059 009 050 ADJ - Table Games TOTALS PROGRESSIVE KENO (Check One)? Yes No SECTION C CODE COUNTER GAMES Keno Bingo Race Book Race Parlay Cards Race Pari-Mutuel Sports Parlay Cards Sports Pool Football Basketball Baseball Sports Pari-Mutuel ADJ - Counter Games NO. OF UNITS WRITE ($) GROSS REVENUE ($) ACCOUNTING METHOD USED FOR RECORDING RACE AND SPORTS BOOK REVENUE (Please Check One): CASH: All cash wager received for the day less all cash paid out for day. MODIFIED ACCRUAL: All wagers for the events completed for the day less cash paid out. The HASH TOTAL is a number comprised of the following subtotals added together. SECTION A ("NO. OF UNITS" TOTAL ("COINS IN" TOTAL) ("DROP" TOTAL) SECTION B ("NO. OF UNITS" TOTAL CONVERTED TO DOLLARS) ("PIT CREDIT ISSUES" TOTAL) ("PIT CREDIT PAYMENTS" (CHIPS) TOTAL) ("PIT CREDIT PAYMENTS (CASH) TOTAL) ("DROP" TOTAL) ("WIN" TOTAL) SECTION C SECTION D ("NO. OF UNITS" TOTAL CONVERTED TO DOLLARS) ("WRITE" TOTAL) ("NO. OF UNITS" TOTAL CONVERTED TO DOLLARS) CONVERTED TO DOLLARS) 025 026 035 048 052 034 036 004 008 033 058 051 Totals SECTION D CODE NO. OF UNITS CARD GAMES Poker Pan Other Card Games Interactive Poker ADJ - Card Games GROSS REVENUE ($) 030 031 032 060 054 TOTALS TOTAL GROSS REVENUE (Add Sections A, B, C, D) HASH TOTAL I, , certify and declare under the penalties of perjury that I am the (Owner,Partner,President,Treasurer,Other) Enter on Line 1- Form NGC-1 of the business named above; that this is a true, correct and complete report to the best of my knowledge, information, and belief, and that this report is made with the knowledge and consent of all other individuals licensed. Dated Signed Person to contact regarding this report: Name Phone # Please return to State Gaming Board, Tax and License Division P.O. Box 8004, Carson City, NV 89702-8004 American LegalNet, Inc. www.FormsWorkFlow.com
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