Spreadsheet: 1604d9da-9b4d-4e01-b3da-ce61d38c6ebc
Sheet: Sheet1

MONTH / YEAR | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12 | Unnamed: 13
LICENSE #
CASINO NAME |  |  |  |  | TAX TEMPLATE
PREPARED BY
DATE COMPLETED
REVIEWED BY (2nd Level Review)
DATE REVIEWED
RECONCILIATION OF SLOT MACHINE STATISTICAL REPORTS
STEP 1:   THE FOLLOWING WORKSHEET WILL ASSIST IN TYING OUT ALL STATISTICAL REPORTS.   ENTER THE REQUESTED INFORMATION IN THE YELLOW BOXES.   VARIANCES AND ERRORS WILL APPEAR IN RED.   CORRECT ANY ERRORS.  REMAINING VARIANCES MUST BE EXPLAINED.   THE DATA IN THE ROWS WITH NUMBER NOTATIONS WILL AUTOMATICALLY FLOW TO A CALCULATION CHART.
COIN-IN
Coin-in | 0.01 | 0.05 | 0.1 | 0.25 | 0.5 | 1 | 2 | 5 | 10 | 25 | 100 | Multi-Denom | TOTAL
Theoretical Hold Report | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
MSRS  (1) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
For any differences in above numbers, investigate and correct any errors.  Remaining variances must be explained below:
"DROP" ON TAX RETURN = [NAME] (bill & coin) + Ticket Drop + Slot Coupon Drop + Electronic-In + Tournament AGP
[NAME] (bill & coin) | 0.01 | 0.05 | 0.1 | 0.25 | 0.5 | 1 | 2 | 5 | 10 | 25 | 100 | Multi-Denom | TOTAL
MSRS  (2) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
Drop Comparison Report | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
Theoretical Hold Report | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
General Ledger | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
For any differences in above numbers, investigate and correct any errors.  Remaining variances must be explained below:
Ticket & Slot Coupon Drop | 0.01 | 0.05 | 0.1 | 0.25 | 0.5 | 1 | 2 | 5 | 10 | 25 | 100 | Multi-Denom | TOTAL
MSRS  (3) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
Ticket-In Comparison Report | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
Theoretical Hold Report | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
General Ledger | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
For any differences in above numbers, investigate and correct any errors.  Remaining variances must be explained below:
Electronic-In | 0.01 | 0.05 | 0.1 | 0.25 | 0.5 | 1 | 2 | 5 | 10 | 25 | 100 | Multi-Denom | TOTAL
Electronic-In Comparison Report  (4) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
General Ledger | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
For any differences in above numbers, investigate and correct any errors.  Remaining variances must be explained below:
Slot Tournament AGP | 0.01 | 0.05 | 0.1 | 0.25 | 0.5 | 1 | 2 | 5 | 10 | 25 | 100 | Multi-Denom | TOTAL
Slot Tournament Summary Form  (5) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
General Ledger | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
For any differences in above numbers, investigate and correct any errors.  Remaining variances must be explained below:
"PAYOUTS" ON TAX RETURN = Payouts + Tickets Redeemed + Fills + Electronic-Out - JP Adjustments
Payouts (JP, CC & Prog.) | 0.01 | 0.05 | 0.1 | 0.25 | 0.5 | 1 | 2 | 5 | 10 | 25 | 100 | Multi-Denom | TOTAL
MSRS  (6) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
[NAME] | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
Theoretical Hold Report | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
General Ledger | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
For any differences in above numbers, investigate and correct any errors.  Remaining variances must be explained below:
Tickets Redeemed | 0.01 | 0.05 | 0.1 | 0.25 | 0.5 | 1 | 2 | 5 | 10 | 25 | 100 | Multi-Denom | TOTAL
MSRS  (7) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
General Ledger | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
For any differences in above numbers, investigate and correct any errors.  Remaining variances must be explained below:
Fills | 0.01 | 0.05 | 0.1 | 0.25 | 0.5 | 1 | 2 | 5 | 10 | 25 | 100 | Multi-Denom | TOTAL
MSRS  (8) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
Theoretical Hold Report | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
General Ledger | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
For any differences in above numbers, investigate and correct any errors.  Remaining variances must be explained below:
Electronic-Out | 0.01 | 0.05 | 0.1 | 0.25 | 0.5 | 1 | 2 | 5 | 10 | 25 | 100 | Multi-Denom | TOTAL
Electronic-Out Comparison Report  (9) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
General Ledger | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
For any differences in above numbers, investigate and correct any errors.  Remaining variances must be explained below:
[NAME] | 0.01 | 0.05 | 0.1 | 0.25 | 0.5 | 1 | 2 | 5 | 10 | 25 | 100 | Multi-Denom | TOTAL
[NAME] | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
Unclaimed Jackpots | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
JP Adjustments Total  (10) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
NOTE:  This area will only be completed if overpaid jackpots and unclaimed jackpots are included in drop period statistical reports.
HOPPER ADJUSTMENTS
[NAME] | 0.01 | 0.05 | 0.1 | 0.25 | 0.5 | 1 | 2 | 5 | 10 | 25 | 100 | Multi-Denom | TOTAL
MSRS  (11) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
NOTE:   If the hopper amount was MORE than the initial fill, enter the adjustment as a POSITIVE number.
If the hopper amount was LESS than the initial fill, enter the adjustment as a NEGATIVE number.
STATEWIDE CONTRIBUTIONS
Statewide Contributions | 0.01 | 0.05 | 0.1 | 0.25 | 0.5 | 1 | 2 | 5 | 10 | 25 | 100 | Multi-Denom | TOTAL
[NAME]  (12) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
[NAME]
Secondary Jackpots | 0.01 | 0.05 | 0.1 | 0.25 | 0.5 | 1 | 2 | 5 | 10 | 25 | 100 | Multi-Denom | TOTAL
Paid by Casino  (13) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
TICKETS ISSUED  -  For reconciliation purposes only, will not be used on Tax Return
Tickets Issued | 0.01 | 0.05 | 0.1 | 0.25 | 0.5 | 1 | 2 | 5 | 10 | 25 | 100 | Multi-Denom | TOTAL
Theoretical Hold Report | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
Ticket-Out Comp. Report | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
For any differences in above numbers, investigate and correct any errors.  Remaining variances must be explained below:
CALCULATION CHART FOR TAX RETURN (SLOT MACHINES)
STEP 2:   ENTER THE AMOUNTS APPEARING IN THE BLUE BOXES ON THE TAX RETURN.   DO NOT SUBMIT THE TAX RETURN YET.
 | 0.01 | 0.05 | 0.1 | 0.25 | 0.5 | 1 | 2 | 5 | 10 | 25 | 100 | Multi-Denom | TOTAL
1.  COIN-IN | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
2.  [NAME] (bill & coin) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
3.  Ticket Drop & Slot Coupon Drop | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
4.  Electronic-In | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
5.  Slot Tournament AGP | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
TOTAL DROP | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
6.  Payouts (JP, CC & Prog.) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
7.  Tickets Redeemed | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
8.  Fills | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
9.  Electronic-Out | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
10. [NAME] | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
TOTAL PAYOUTS | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
11.  HOPPER ADJUSTMENTS | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
12.  [NAME]. | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
13.  SECONDARY JACKPOTS | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
ADJUSTED GROSS PROCEEDS | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
NOTE:  The Adjusted Gross Proceeds (AGP) may be different on the MSRS, Theoretical Hold Report and the Tax Return.  The different amounts may be a result of unredeemed tickets (liability), hopper adjustments, and statewide contributions.
RECONCILIATION OF TABLE GAMES STATISTICAL REPORTS
STEP 3:   COMPLETE THE FOLLOWING WORKSHEETS FOR TABLES GAMES AND ADJUSTMENTS.
BLACKJACK |  |  |  |  |  |  | HOUSE BANKED POKER
ENTER THE REQUESTED INFORMATION IN THE YELLOW BOXES. |  |  |  |  |  |  | ENTER THE REQUESTED INFORMATION IN THE YELLOW BOXES.
DROP |  |  |  |  |  |  | DROP
Blackjack Master Games Summary Report |  |  | 0 |  |  |  |  |  |  |  | HB Poker Master Games Summary Report | 0
Blackjack Tournament AGP |  |  | 0 |  |  |  |  |  |  |  | HB Poker Tournament AGP | 0
[NAME] Total |  |  | 0 | [A] |  |  |  |  |  |  | HB Poker Drop Total | 0 | [A]
 | General Ledger |  | 0 | [B] |  |  |  |  |  |  | General Ledger | 0 | [B]
Explain any difference between [A] and [B] below: |  |  |  |  |  |  | Explain any difference between [A] and [B] below:
HANDPAYS |  |  |  |  |  |  | HANDPAYS
[NAME] |  |  | 0 | [C] |  |  |  |  |  |  | HB Poker Handpaid Jackpots | 0 | [C]
 | General Ledger |  | 0 | [D] |  |  |  |  |  | General Ledger |  | 0 | [D]
Explain any difference between [C] and [D] below: |  |  |  |  |  |  | Explain any difference between [C] and [D] below:
PAYOUTS |  |  |  |  |  |  | PAYOUTS
Blackjack Openers |  |  | 0 |  |  |  |  |  |  |  | HB Poker Openers | 0
Plus Blackjack Fills |  |  | 0 |  |  |  |  |  |  |  | Plus HB Poker Fills | 0
Minus Blackjack Closers |  |  | 0 |  |  |  |  |  |  |  | Minus HB Poker Closers | 0
Minus Blackjack Credits |  |  | 0 |  |  |  |  |  |  |  | Minus HB Poker Credits | 0
Blackjack Fill/Credit Adjustment Total |  |  | 0 | [E] |  |  |  |  |  |  | HB Poker Fill/Credit Adjustment Total | 0 | [E]
 | General Ledger |  | 0 | [F] |  |  |  |  |  | General Ledger |  | 0 | [F]
Explain any difference between [E] and [F] below: |  |  |  |  |  |  | Explain any difference between [E] and [F] below:
ADJUSTED GROSS PROCEEDS |  |  |  |  |  |  | ADJUSTED GROSS PROCEEDS
 |  | Blackjack AGP | 0 |  |  |  |  |  |  |  | HB Poker AGP | 0
ENTER [A], [C] AND [E] ON THE TAX RETURN.  VERIFY AGP ON TAX RETURN |  |  |  |  |  |  | ENTER [A], [C] AND [E] ON THE TAX RETURN.  VERIFY AGP ON TAX
TO ABOVE. |  |  |  |  |  |  | RETURN TO ABOVE.
ROULETTE |  |  |  |  |  |  | CRAPS
ENTER THE REQUESTED INFORMATION IN THE YELLOW BOXES. |  |  |  |  |  |  | ENTER THE REQUESTED INFORMATION IN THE YELLOW BOXES.
DROP |  |  |  |  |  |  | DROP
Roulette Master Games Summary Report |  |  | 0 |  |  |  |  |  |  |  | Craps Master Games Summary Report | 0
[NAME] Tournament AGP |  | [NAME] Tournament AGP | 0 |  |  |  |  |  |  |  | Craps Tournament AGP | 0
[NAME] Total |  | [NAME] Total | 0 | [A] |  |  |  |  |  |  | Craps Drop Total | 0 | [A]
 | General Ledger |  | 0 | [B] |  |  |  |  |  |  | General Ledger | 0 | [B]
Explain any difference between [A] and [B] below: |  |  |  |  |  |  | Explain any difference between [A] and [B] below:
HANDPAYS |  |  |  |  |  |  | HANDPAYS
[NAME] |  |  | 0 | [C] |  |  |  |  |  |  | Craps Handpaid Jackpots | 0 | [C]
 | General Ledger |  | 0 | [D] |  |  |  |  |  | General Ledger |  | 0 | [D]
Explain any difference between [C] and [D] below: |  |  |  |  |  |  | Explain any difference between [C] and [D] below:
PAYOUTS |  |  |  |  |  |  | PAYOUTS
[NAME] |  |  | 0 |  |  |  |  |  |  |  | Craps Openers | 0
Plus Roulette Fills |  |  | 0 |  |  |  |  |  |  |  | Plus Craps Fills | 0
Minus [NAME] |  |  | 0 |  |  |  |  |  |  |  | Minus CrapsClosers | 0
Minus [NAME] |  |  | 0 |  |  |  |  |  |  |  | Minus Craps Credits | 0
[NAME] |  |  | 0 | [E] |  |  |  |  |  |  | Craps Fill/Credit Adjustment Total | 0 | [E]
 | General Ledger |  | 0 | [F] |  |  |  |  |  | General Ledger |  | 0 | [F]
Explain any difference between [E] and [F] below: |  |  |  |  |  |  | Explain any difference between [E] and [F] below:
ADJUSTED GROSS PROCEEDS |  |  |  |  |  |  | ADJUSTED GROSS PROCEEDS
 |  | [NAME] AGP | 0 |  |  |  |  |  |  |  | Craps AGP | 0
ENTER [A], [C] AND [E] ON THE TAX RETURN.  VERIFY AGP ON TAX RETURN |  |  |  |  |  |  | ENTER [A], [C] AND [E] ON THE TAX RETURN.  VERIFY AGP ON TAX
TO ABOVE. |  |  |  |  |  |  | RETURN TO ABOVE.
PLAYER BANKED POKER |  |  |  |  |  |  | ADJUSTMENTS - PENALTY - INTEREST
ENTER THE REQUESTED INFORMATION IN THE YELLOW BOXES. |  |  |  |  |  |  | ENTER APPLICABLE INFORMTION FOR ANY ADJUSTMENTS IN THE YELLOW BOXES.
DROP |  |  |  |  |  |  | ADJUSTMENTS EXPLANATION
PB Poker Master Games Summary Report |  |  | 0
PB Poker Tournament AGP |  |  | 0 |  |  |  |  |  |  | Adjustments |  | 0
PB Poker Drop Total |  |  | 0 | [A] |  |  |  |  |  | Penalty |  | 0
 | General Ledger |  | 0 | [B] |  |  |  |  |  | Interest |  | 0
Explain any difference between [A] and [B]
 |  |  |  |  |  |  | Explanation:
ADJUSTED GROSS PROCEEDS
 | PB Poker AGP |  | 0
ENTER [A] ON THE TAX RETURN. |  |  |  |  |  |  | ATTACH COPIES OF DOCUMENTATION FROM THE DIVISION OF GAMING.
STEP 4:   PRINT THE TAX RETURN.   DO NOT SUBMIT THE TAX RETURN YET.
TAX RETURN VERIFICATION
STEP 5:   COMPLETE THE YELLOW BOXES IN THE FOLLOWING WORKSHEET USING INFORMATION FROM THE TAX RETURN.   ANY ERRORS (NUMBERS APPEARING IN RED) MUST BE CORRECTED BEFORE SUBMITTING THE TAX RETURN.
 | 0.01 | 0.05 | 0.1 | 0.25 | 0.5 | 1 | 2 | 5 | 10 | 25 | 100 | Multi-Denom | TOTAL
COIN-IN | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
TOTAL DROP | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
TOTAL PAYOUTS | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
HOPPER ADJUSTMENTS | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
STATEWIDE CONTRIBUTIONS | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
SECONDARY JACKPOTS | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
ADJUSTED GROSS PROCEEDS | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
BLACKJACK - DROP |  | 0 |  |  | HOUSE BANKED POKER - DROP |  |  |  | 0
BLACKJACK - HANDPAY |  | 0 |  |  | HOUSE BANKED POKER - HANDPAY |  |  |  | 0
BLACKJACK - PAYOUTS |  | 0 |  |  | HOUSE BANKED POKER - PAYOUTS |  |  |  | 0
BLACKJACK - AGP |  | 0 |  |  | HOUSE BANKED POKER - AGP |  |  |  | 0
ROULETTE - DROP |  | 0 |  |  | CRAPS - DROP |  |  |  | 0
ROULETTE - HANDPAY |  | 0 |  |  | CRAPS - HANDPAY |  |  |  | 0
ROULETTE - PAYOUTS |  | 0 |  |  | CRAPS - PAYOUTS |  |  |  | 0
ROULETTE - AGP |  | 0 |  |  | CRAPS - AGP |  |  |  | 0
PLAYER BANKED POKER - DROP |  | 0
PLAYER BANKED POKER = AGP |  | 0
STEP 6:   SUBMIT THE TAX RETURN.  PRINT THE TAX TEMPLATE AND RETAIN WITH COPY OF TAX RETURN.