INSTRUCTIONS: ARIZONA ANNUAL FINANCIAL REPORT FOR BINGO LICENSE CLASS "A" (Form 71-1013)

Arizona bingo games conducted by an establishment with a class "A" license document their proceeds using a form 71-1013. This document can be obtained from the website of the Arizona Department of Revenue.

Arizona Annual Financial Report For Bingo License Class "A" 71-1013 Step 1: Enter the beginning and ending dates of your financial reporting period.

Arizona Annual Financial Report For Bingo License Class "A" 71-1013 Step 2: Indicate with a check mark if this is an amended report.

Arizona Annual Financial Report For Bingo License Class "A" 71-1013 Step 3: In the first blank box, enter the licensee's name and address.

Arizona Annual Financial Report For Bingo License Class "A" 71-1013 Step 4: In the second blank box, enter the license number.

Arizona Annual Financial Report For Bingo License Class "A" 71-1013 Step 5: In the third blank box, enter the licensee's phone number, including the area code.

Arizona Annual Financial Report For Bingo License Class "A" 71-1013 Step 6: On line 1, enter your gross receipts.

Arizona Annual Financial Report For Bingo License Class "A" 71-1013 Step 7: On line 2, enter the prizes paid out.

Arizona Annual Financial Report For Bingo License Class "A" 71-1013 Step 8: Subtract line 2 from line 1. Enter the resulting difference on line 3. This figure represents your adjusted gross receipts.

Arizona Annual Financial Report For Bingo License Class "A" 71-1013 Step 9: On line 4, enter the bingo expenses paid. You should provide a brief description of any bingo expenses paid such as bingo paper, daubers or other supplies. Attach a separate page listing the purpose and amount of each expense.

Arizona Annual Financial Report For Bingo License Class "A" 71-1013 Step 10: On line 5, enter the expenditures of net proceeds.

Arizona Annual Financial Report For Bingo License Class "A" 71-1013 Step 11: Multiply the amount on line 3 by 2.5%. Enter the resulting product on line 6. a

Arizona Annual Financial Report For Bingo License Class "A" 71-1013 Step 12: Enter the penalty and interest due, if any, on line 7.

Arizona Annual Financial Report For Bingo License Class "A" 71-1013 Step 13: Add lines 6 and 7. Enter the resulting sum on line 8. Sign and date the form and enter your title at the bottom of the page.