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www.michigan.gov/cgBINGO GAME FORMS PACKETzBingo Weekly Cash AccountabilityzBingo Master Control SheetzDisposable Bingo Card AccountabilityzMichigan Progressive Jackpot Bingo GamezDisposable Bingo Card Monthly InventoryzBingo Prize Payout LogzBingo Coverall RecordzMichigan Progressive Jackpot Coverall RecordzWorkers Service RecordzCharity Game Ticket Accountability (Bingo License)zCharity Game Ticket ReconciliationBSL-CG-1423P(R4/16)
BINGO WEEKLY CASH ACCOUNTABILITYCharitable Gaming Division101 E. Hillsdale, Box 30023Lansing, Michigan 48909(517) 335-5786www.michigan.gov/cgOrganization NameLicense NumberVerification Slip Beginning # Ending #Event DateAttendanceBingo Revenue:1. Admission / Bingo CardsMaster Control Disposable Bingo Card Acc’t. Electronic 2. Michigan Progressive Jackpot Card Sales .3. Other Revenue (sales of supplies).4. Total Revenue (add lines 1 - 3).Bingo Cash Expenses:5. Michigan Progressive Jackpot Consolation Prize (cash) .6. Other Cash Prizes .7. Worker Compensation .8. Total Bingo Cash Expenses (add lines 5 - 7).9. Bingo Cash Proceeds (subtract line 8 from line 4) .Charity Game Tickets:10. Ticket Sales .11. Prizes .12. Charity Game Ticket Gross Profit (subtract line 11 from line 10) .Reconcile Cash:13. Net Proceeds (add lines 9 & 12).14. Start Cash (if deposited weekly) .15. Calculated Deposit (add lines 13 & 14).16. Actual Deposit .17. Discrepancy (subtract line 16 from line 15).Signature of RecordkeeperSignature of ChairpersonCOMPLETION: Required.PENALTY: Failure to complete this formmay result in administrative action.Authority: Act 382 of the Public Acts of 1972, as amended.BSL-CG-1755(R4/06)
Charitable Gaming Division101 E. Hillsdale, Box 30023Lansing, Michigan 48909(517) 335-5786www.michigan.gov/cgOrganization INGO MASTER CONTROL SHEETCompleted By# Books # Books # Books # Books # Books 91840Event DateLicense NumberReg.HardCards# Books # Books # Books # Books # Books TotalSalesTotals192021Total Sales*22Actual CashDiscrepancy Totals* Enter this amount on the Bingo W eekly Cash Accountability form.Authority: Act 382 of the Public Acts of 1972, as amended. -COMPLETION: Required.PENALTY: Failure to complete this formmay result in administrative action.BSL-CG-1625A(R4/06)
Charitable Gaming Division101 E. Hillsdale, Box 30023Lansing, Michigan 48909(517) 335-5786www.michigan.gov/cgOrganization INGO MASTER CONTROL SHEETCompleted By# Books # Books # Books # Books # Books 775678577958805981608261836284TotalsAuthority: Act 382 of the Public Acts of 1972, as amended.License NumberReg.HardCardsEvent Date# Books # Books # Books # Books # Books TotalSalesTotalsCOMPLETION: Required.PENALTY: Failure to complete this formmay result in administrative action.BSL-CG-1625B(R4/06)
Charitable Gaming Division101 E. Hillsdale, Box 30023Lansing, Michigan 48909(517) 335-5786www.michigan.gov/cgOrganization INGO MASTER CONTROL SHEETCompleted By# Books # Books # Books # Books # Books 127106128TotalsAuthority: Act 382 of the Public Acts of 1972, as amended.License NumberReg.HardCardsEvent Date# Books # Books # Books # Books # Books TotalSalesTotalsCOMPLETION: Required.PENALTY: Failure to complete this formmay result in administrative action.BSL-CG-1625C(R4/06)
Charitable Gaming Division101 E. Hillsdale, Box 30023Lansing, Michigan 48909(517) 335-5786www.michigan.gov/cgOrganization INGO MASTER CONTROL SHEETCompleted By# Books # Books # Books # Books # Books 147169148170149171150172TotalsAuthority: Act 382 of the Public Acts of 1972, as amended.License NumberReg.HardCardsEvent Date# Books # Books # Books # Books # Books TotalSalesTotalsCOMPLETION: Required.PENALTY: Failure to complete this formmay result in administrative action.BSL-CG-1625D(R4/06)
Charitable Gaming Division101 E. Hillsdale, Box 30023Lansing, Michigan 48909(517) 335-5786www.michigan.gov/cgOrganization INGO MASTER CONTROL SHEETCompleted By# Books # Books # Books # Books # Books 191213192214193215194216TotalsAuthority: Act 382 of the Public Acts of 1972, as amended.License NumberReg.HardCardsEvent Date# Books # Books # Books # Books # Books TotalSalesTotalsCOMPLETION: Required.PENALTY: Failure to complete this formmay result in administrative action.BSL-CG-1625E(R4/06)
Charitable Gaming Division101 E. Hillsdale, Box 30023Lansing, Michigan 48909(517) 335-5786www.michigan.gov/cgOrganization INGO MASTER CONTROL SHEETCompleted By# Books # Books # Books # Books # Books 235257236258237259238260TotalsAuthority: Act 382 of the Public Acts of 1972, as amended.License NumberReg.HardCardsEvent Date# Books # Books # Books # Books # Books TotalSalesTotalsCOMPLETION: Required.PENALTY: Failure to complete this formmay result in administrative action.BSL-CG-1625F(R4/06)
Charitable Gaming Division101 E. Hillsdale, Box 30023Lansing, Michigan 48909(517) 335-5786DISPOSABLE BINGO CARD ACCOUNTABILITYwww.michigan.gov/cgOrganization NameLicense NumberCompleted ByEvent DateFLOOR SALESColor 1Color 2Worker’s NameOutInNo.SoldPrice SalesCashInCashOver/ShortOutInNo.SoldPrice SalesCashInCashOver/ShortInNo.SoldPrice SalesCashInCashOver/ShortTotalsColor 3Color 4Worker’s NameOutInNo.SoldPrice SalesCashInCashOver/ShortOutTotalsDOOR SALESType/Color of CardOutInNo.SoldPriceSalesCash InCashOver/ShortTotalSalesFloor - Color 1Floor - Color 2Floor - Color 3Floor - Color 4Total Page 2Door SalesTotal Sales*Totals* Enter this amount on the Bingo W eekly Cash Accountability forms.Authority: Act 382 of the Public Acts of 1972, as amended.COMPLETION: Required.PENALTY: Failure to complete this formmay result in administrative action.BSL-CG-1180(R4/06)
FLOOR SALES (continued)Color 5Color 6Worker’s NameOutInNo.SoldPrice SalesCashInCashOver/ShortOutInNo.SoldPrice SalesCashInCashOver/ShortInNo.SoldPrice SalesCashInCashOver/ShortInNo.SoldPrice SalesCashInCashOver/ShortTotalsColor 7Color 8Worker’s NameOutInNo.SoldPrice SalesCashInCashOver/ShortOutTotalsColor 9Color 10Worker’s NameOutInNo.SoldPrice SalesCashInCashOver/ShortOutTotalsColor 11TotalSalesWorker’s NameOutInNo.SoldPrice SalesCashInCashOver/ShortFloor - Color 5Floor - Color 6Floor - Color 7Floor - Color 8Floor - Color 9Floor - Color 10TotalsFloor - Color 11Color 12Floor - Color 12Worker’s NameOutInNo.SoldPrice SalesCashInCashOver/ShortTotal Page 2
Charitable Gaming Division101 E. Hillsdale, Box 30023Lansing, Michigan 48909(517) 335-5786www.michigan.gov/cgMICHIGAN PROGRESSIVE JACKPOT BINGO GAMEOrganization NameSALESCompleted ByLicense NumberEvent Date(No discounting)Worker’s NameType/ColorOutInNo. SoldPriceSalesCash InCashOver/ShortDOORDOORTotals**Enter this amount on the Bingo Weekly Cash Accountability form.PRIZE ACCOUNTABILITY1. Fifty (50) percent of total sales 2. Prior occasion’s progressive jackpot prize 3. Progressive jackpot prize or amount carried forward 4. Number of calls required to win progressive jackpot5. If progressive jackpot prize awarded, enter check number6. Consolation prize awarded(If paid in cash, list amount on Bingo W eekly Cash Accountability form.) NOTE: The progressive jackpot is based on the number of sheets (cards) sold, not the amount of moneycollected. If a worker is short, the organization is short. You may not short the prize money.COMPLETION: Required.PENALTY: Failure to complete this formmay result in administrative action.Authority: Act 382 of the Public Acts of 1972, as amended.BSL-CG-1708(R4/06)
Begi nni ngInventoryInvoi ce #Invoi ce #PurchasesAuthority: Act 382 of the Public Acts of 1972, as amended.Type/C olor of C ardOrganization NameCharitable Gaming Division101 E. Hillsdale, Box 30023Lansing, Michigan 48909(517) 335-5786www.michigan.gov/lotteryWeek 1SoldWeek 2SoldCompleted ByWeek 3SoldWeek 4SoldWeek 5SoldP aperSpoi lageLicense NumberEnd of MonthInventoryD i fferenceBSL-CG-1333(R4/06)COMPLETION: Required.PENALTY: Failure to complete this formmay result in administrative action.ActualInventoryMonthDISPOSABLE BINGO CARD MONTHLY INVENTORY
Charitable Gaming Division101 E. Hillsdale, Box 30023Lansing, Michigan 48909(517) 335-5786www.michigan.gov/cgOrganization NameBINGO PRIZE PAYOUT LOGCompleted ByEvent DateLicense NumberName of Players Verifying the Bingo BallsGames (in order played)Number ofWinnersTotalsMerchandise/Check PrizesCash PrizesAccumulated Prize Total** Enter this amount on the Bingo W eekly Cash Accountability form.COMPLETION: Required.PENALTY: Failure to complete this formmay result in administrative action.Authority: Act 382 of the Public Acts of 1972, as amended.BSL-CG-1173(R4/06)
Charitable Gaming Division101 E. Hillsdale, Box 30023Lansing, Michigan 48909(517) 335-5786www.michigan.gov/cgBINGO COVERALL RECORDOrganization NameNo.1 stCompleted By2nd3rd4th5thNo.1 st2ndEvent DateLicense 9742550751 st2nd3rd4th5thCOMPLETION: Voluntary.Authority: Act 382 of the Public Acts of 1972, as amended.BSL-CG-1178(R4/06)
Charitable Gaming Division101 E. Hillsdale, Box 30023Lansing, Michigan 48909(517) 335-5786www.michigan.gov/cgOrganization NameMICHIGAN PROGRESSIVE JACKPOTCOVERALL RECORDCompleted ByLicense NumberEvent ETION: Required.PENALTY: Failure to complete this formmay result in administrative action.Authority: Act 382 of the Public Acts of 1972, as amended.BSL-CG-1994(R4/06)
Charitable Gaming Division101 E. Hillsdale, Box 30023Lansing, Michigan 48909(517) 335-5786www.michigan.gov/cgWORKERS SERVICE RECORDComplete this form for your records. Do not mail in.All rules governing worker compensation shall be adhered to when completing this form. Review the following rules to ensure coBingo Rule 326 and 327; Millionaire Party Rule 412 and 413; Raffle Rule 516; and Charity Game Ticket Rule 617.License NumberOrganization NameSignaturempliance:Print NameWorker Titlee.g., chairperson,recordkeeper, or workerAmountPaidDateWorkedTotalSignature of ChairpersonDateCOMPLETION: Required.PENALTY: Failure to complete this form mayresult in administrative action.Authority: Act 382 of the Public Acts of 1972, as amended.BSL-CG-1724(R12/05)
TicketInformationCash Turned InNumber ofTickets OutAuthority: Act 382 of the Public Acts of 1972, as amended.* Enter these amounts on the Bingo W eekly Cash Accountability form.Worker’s NameWorker’sNameOrganization NameCharitable Gaming Divison101 E. Hillsdale, Box 30023Lansing, Michigan 48909(517) 335-5786www.michigan.gov/cgNumber ofTickets InWorker’s Name Tickets SoldCompleted byTotals Ticket SalesWinning Tickets Turned InXPrice PerTicketLicense Number** Gross ProfitBSL-CG-1511(R4/06)COMPLETION: Required.PENALTY: Failure to complete this form mayresult in administrative action.DiscrepancyActual CashPrizesEvent DateCHARITY GAME TICKET ACCOUNTABILITY(BINGO LICENSE)
2184# TicketsPer BoxBeginningPurchasesboxes x ticketsInventoryper boxloose & ticketsin boxes Authority: Act 382 of the Public Acts of 1972, as amended.Deposit of charity game ticket proceeds for period Criss CrossGame NameOrganization NameCharitable Gaming Division101 E. Hillsdale, Box 30023Lansing, Michigan 48909(517) 335-5786www.michigan.gov/cg TicketsSoldDifference 1xPriceLicense Number TicketSales x.75PrizesThruPrizePayout %FromPeriodThis form is recommended to reduce the risk of lossof proceeds from the sale of charity game tickets.Totals from Financial StatementTotals from this formEndingInventoryloose & ticketsin boxesCompleted byBSL-CG-1718(4/07)COMPLETION: Voluntary. GrossProfitCHARITY GAME TICKET RECONCILIATION
Inventory urchasesP1 Week Sold Week2 Sold Week3 Sold Week4 Sold Week5 Sold Paper Spoilage EndofMonth Inventory Actual Inventory Difference nvoice#I# Invoice DISPOSABLE BINGO CARD MONTHLY INVENTORY Completed By License Number Month Authority: Act 382 of the Public Acts of 1
