Monthly Gross Revenue Statistical Report - Gaming Salon {NGC-30}

NGC-30 (04-01-18) For Office Use Only Please correct if in error CODE CODE TABLE GAMES TOTALS CODE 025 026 035 048 052 034 036 004 008 033 x-none058x-none051x-noneCODEx-none030x-none031x-none032x-none060x-none054x-noneI,x-none, certify and declare under the penalties of perjury that I am thex-noneSignedx-noneNamex-nonePhone # x-nonethe Nevada Gaming Control Board. x-none NEVADA GAMING COMMISSION x-noneMONTHLY GROSS REVENUE STATISTICAL REPORT GAMING SALON x-nonePeriod Covered: x-noneFiling Deadline: x-noneAccount Number: x-noneCheck Number x-noneLegal Name: x-noneTrade Name: x-noneBatch Number x-noneAddress: x-noneCity, State, Zip: x-noneEntry Date x-nonePlease correct if in error x-noneSECTION A x-noneNO. OF UNITS x-noneCOINS IN ($) x-noneDROP ($) x-noneGROSS REVENUE ($) x-noneSLOT MACHINES x-noneTOTALS x-noneSECTION B x-noneNO. OF UNITS x-nonePIT CREDIT ISSUES ($) x-nonePIT CREDIT PAYMENT (CHIPS)($) x-nonePIT CREDIT PAYMENT (CASH)($) x-noneDROP ($) x-noneWIN ($) x-noneGROSS REVENUE ($) x-noneSECTION C x-noneNO. OF UNITS x-noneWRITE ($) x-noneGROSS REVENUE ($) x-noneCOUNTER GAMES x-noneNote: This form is for informational purposes only. All revenue on this form must be included in the revenue totals recorded on the NGC-31 (Monthly Gross Revenue Statistical Report.) x-noneKeno x-noneBingo x-noneRace Book x-noneRace Parlay Cards x-noneRace Pari-Mutuel x-noneSports Parlay Cards x-noneSports Pool x-noneThe HASH TOTAL is a number comprised of the following subtotals added together. x-noneFootball x-noneBasketball x-noneBaseball x-noneSECTION A ("NO. OF UNITS" TOTAL CONVERTED TO DOLLARS) x-noneSports Pari-Mutuel x-none ("COINS IN" TOTAL) x-noneADJ - Counter Games x-none ("DROP" TOTAL) x-noneTOTALS x-noneSECTION B ("NO. OF UNITS" TOTAL CONVERTED TO DOLLARS) x-noneSECTION D x-noneNO. OF UNITS x-noneGROSS REVENUE ($) x-none ("PIT CREDIT ISSUES" TOTAL) x-noneCARD GAMES x-none ("PIT CREDIT PAYMENTS" (CHIPS) TOTAL) x-nonePoker x-none ("PIT CREDIT PAYMENTS (CASH) TOTAL) x-nonePan x-none ("DROP" TOTAL) x-noneOther Card Games x-none ("WIN" TOTAL) x-noneSECTION C ("NO. OF UNITS" TOTAL CONVERTED TO DOLLARS) x-noneADJ - Card Games x-none ("WRITE" TOTAL) x-noneTOTALS x-noneSECTION D ("NO. OF UNITS" TOTAL CONVERTED TO DOLLARS) x-noneTOTAL GROSS REVENUE (Add Sections A, B, C, D) x-noneHASH TOTAL x-nonePerson to contact regarding this report: x-noneEffective November 1, 2016, pursuant to Nevada Gaming Commission Regulation 6.030, all Nevada Gaming Licensees must x-nonereport and pay their gaming taxes and fees, and all reports relating thereto, pursuant to an electronic transfer approved by x-noneInteractive Poker x-none(Owner,Partner,President,Treasurer,Other) x-noneof the business named above; that this is a true, correct and complete report to the best of my knowledge, information, and belief, x-noneand that this report is made with the knowledge and consent of all other individuals licensed. x-noneDated American LegalNet, Inc. www.FormsWorkFlow.com