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Financial Statement Of Club Operations Form. This is a New Hampshire form and can be use in Liquor Commission Statewide.
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Tags: Financial Statement Of Club Operations, New Hampshire Statewide, Liquor Commission
FORM NO. 233
as REVISED
FEB 00
P.O. Box 1795
Concord NH
03302-1795
State of New Hampshire
STATE LIQUOR COMMISSION
FINANCIAL STATEMENT OF CLUB OPERATIONS
NAME OF CLUB
Address
Statement for Month Ending
City or Town
Membership to Date
20
License No.
STATEMENT OF PROFIT AND LOSS
INCOME FOR MONTH
Sale of Liquor
Sale of Beer
Dues
Miscellaneous (Itemize in space (e) below)
(a) Total Income
OPERATING EXPENSES
Rent (Indicate to whom paid in space (d) below)
Salaries (Itemize in space (f) below)
$
Heat, Light, Water, Telephone
Insurance and Interest
Repairs and Alterations
Janitorial Services & Supplies
Taxes
Donations
Licenses
Transportation
Socials & Benefits
Entertainment
Loss and Waste
Contract Service Expense
$
COSTS OF GOODS SOLD
Inventory Beginning:
$
Liquor
Beer
Bar Supplies
Miscellaneous
Total
Add – Purchases:
$
Liquor
Beer
Bar Supplies
Miscellaneous
Total
Merchandise Available
Deduct – Inventory Ending:
Liquor
Beer
Bar Supplies
Miscellaneous
Total
Merchandise Available
(b) Costs of Goods Sold
$
$
$
(c) Total Expenses
$
PROFIT AND LOSS
(a) Total Income
(b) Less – Costs of Goods Sold
Gross Profit (or Loss)
(c) Less – Operating Expenses
Net Profit (or Loss)
$
$
$
Rent (To Whom Paid)
(d)
Name
Amount
Salaries
(f)
$
$
Name
Amount
$
$
Miscellaneous Income
(e)
Itemize
Sundries – Food
Socials Etc.
Commissions
$
$
$
$
$
$
$
$
$
Amount
$
$
$
$
BALANCE SHEET
ASSETS
Checking Account
Savings Account
Cash on Hand
Petty Cash or Change Fund
Merchandize Inventory
Bonds
Real Estate
Furniture and Equipment
Total Assets
First of Month
$
$
$
$
$
$
$
$
$
Last of Month
$
$
$
$
$
$
$
$
$
LIABILITIES & SURPLUS
Accounts Payable
Notes Payable
Mortgage Payable
Taxes Payable
Surplus
Total Liabilities & Surplus
First of Month
$
$
$
$
$
$
Last of Month
$
$
$
$
$
$
Note: Assets for each month should balance with Liabilities and Surplus
– CERTIFICATION TO THE COMMISSIONERS –
I/We certify and affirm declare that all answers herein above contained are true and correct to the best of my/our knowledge and belief and understand that this
statement is made subject to the penalties of unsworn falsification described in RSA 641:3.
(Date)
(Officers Signature)
(Expiration Date)
(Officers Signature)
(Date)
(Title)
(Title)
(Expiration Date)
This Statement shall be forwarded to the Commission prior to the fifteenth (15) day of the following month. Subject to administrative action if late.
– COMMISSION USE –
(Date Received:
Late:
Days)
(Analyzed by:
Date:
)
(Audited by:
Date:
)
– REMARKS –
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