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Monthly Gross Revenue Report NGC-01 - Nevada
| Monthly Gross Revenue 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-01 (09-08-11) NEVADA GAMING COMMISSION Monthly Gross Revenue Report This report, together with your remittance payable to the order of the NEVADA GAMING COMMISSION, is required th to be filed MONTHLY, NOT LATER THAN THE 24 DAY OF THE MONTH, covering the preceding calendar month. For Gaming operations during the month of: Filing Deadline: Account No., Name, Address, Zip Code For Office Use Only Check Number Batch Number Entry Date Please correct if in error 1. GROSS REVENUE before adjustments [from NGC-31] 2. ADJUSTMENTS: A. Cage credit issued B. Collections in areas other than the pit C. Net of return checks D. NET ADJUSTMENTS [Line 2A + 2B +/- 2C] 3. LOSS CARRY-OVER: from [not to exceed Line 1 + Line 2D] Reg. 6.110(7) $ $ 4. GROSS REVENUE $ [Line 1 +/- Line 2 Line 3] 5. LICENSE FEE COMPUTATION: NRS 463.370(1) A. 3.5% of the first $50,000 on line 4 B. 4.5% of the next $84,000 on line 4 C. 6.75% of the remainder of line 4 6. ESTIMATED FEE DUE BASED ON GROSS REVENUE [Line 5A + 5B + 5C] 7. ESTIMATED FEE ADJUSTMENT NRS 463.370(6)(b) A. Current month's actual FEE DUE [Line 6] B. Est. payment on C. Estimated Fee Adjustment [Line 7A 7B] 8. SUBTOTAL [Line 6 +/- Line 7C] 9. CREDIT from PRIOR PERIOD [not to exceed Line 8] Total CREDIT available 10. SUBTOTAL [Line 8 Line 9] 11. ADVANCE ESTIMATED PAYMENT NRS 463.370(3) [THREE (3) times the amount on Line 6] Note: Applies only to the first FULL month of operation for a NEW LICENSEE $ $ $ $ ( ) 12. TOTAL DUE BEFORE PENALTY [Line 10 + Line 11] 13. PENALTY FOR LATE PAYMENT: NRS 463.270(5) A. Fewer than 10 days late: 25% of line 12 but not less than $50 or more than $1000. $ B. Ten or more days late: 25% of line 12, but not less than $50 or more than $5,000. PENALTY DUE [Line 13A or Line 13B] 14. TOTAL AMOUNT DUE: [Line 12 + Line 13] 15. TOTAL REMITTANCE Check Number: $ $ Please make remittance payable to: NEVADA GAMING COMMISSION Return to the State Gaming Control Board, PO Box 8004, Carson City, NV 89702-8004 Pursuant to NRS 353.1467, payments made to the State, in the aggregate, that amount to $10,000.00 or more must be sent electronically. I, (Owner, Partner, President, Treasurer, Other-describe) , certify and declare under the penalties of perjury that I am the 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 application and report is made with the knowledge and consent of all other individuals licensed. Dated Person to contact regarding this report: Name: Signed Phone: RETURN ORIGINAL AND MAKE DUPLICATE FOR YOUR RECORDS American LegalNet, Inc. www.FormsWorkFlow.com
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