Form Cgf 1 PDF Details

For charities and non-profits in Connecticut looking to host bingo games as fundraising events, understanding the CGF-1 form is crucial. This document, dubbed the "Ten Day Bingo Report", is a requirement set forth by the State of Connecticut's Department of Consumer Protection. Its main purpose is to ensure that all bingo activities are conducted within the legal framework established for charitable gaming. It entails a comprehensive accounting of the event's financial outcomes, including detailed reports on revenue and expenses. Organizations must submit this form within ten days following a bingo session, alongside a check payable to the Treasurer, State of Connecticut. The form captures a variety of data points: from basic information about the organization and event specifics (like the date and number of players) to intricate financial details encompassing bingo income, types of sales, total revenue, expenses, net profit or loss, and lists of prize winners. Additionally, there's a schedule for calculating the fee due to the state, based on net receipts from the games. Proper submission of the CGF-1 form not only satisfies regulatory obligations but also reinforces the transparency and accountability of charitable gaming events, ensuring that they contribute positively to their intended causes while complying with the legal standards.

QuestionAnswer
Form NameForm Cgf 1
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesDISBURSEMENTS, E-mail, Breakage, GamingCharitableCT

Form Preview Example

STATE OF CONNECTICUT

TEN DAY BINGO REPORT

DEPARTMENT OF CONSUMER PROTECTION

CGF-1 Rev. 8/11

Charitable Games Accounting

 

165 Capitol Avenue

 

Hartford, CT 06106

 

E-mail: dcp.accounting@ct.gov

 

Web site: www.ct.gov/dcp

 

ATTENTION: 1.

File completed report within 10 days after bingo session.

 

2.

Submit check payable to the Treasurer, State of Connecticut.

PERMIT NUMBER

3.

Mail report to 165 Capitol Ave., Hartford, CT 06106.

 

 

 

NAME OF ORGANIZATION

TELEPHONE NUMBER

ADDRESS (No. and Street)

(City or Town)

(State)

(Zip Code)

DATE OF SESSION

DAY OF SESSION

TIME OF SESSION

NUMBER OF PLAYERS

 

 

 

 

 

 

 

 

 

 

 

 

 

pm to

 

 

pm

 

 

A. REVENUE

 

SCHEDULE 1. BINGO INCOME STATEMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPE OF

Identifiable

WTA #1

WTA #2

 

Package

Special #1

Special #2

 

Special #3

Special #4

Special #5

Special #6

Special #7

 

SALE

Admissions

 

Sales

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OF CARDS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PRICE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RECEIPTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPE OF

Special #8

Special #9

Special #10

Special #11

Special #12

Special #13

 

Special #14

Special #15

Special #16

Special #17

Special #18

 

SALE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OF CARDS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PRICE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RECEIPTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

 

Total bingo game receipts (from schedule above) ……………………………………...…………………...… $

 

 

2.

 

Sales of supplies

…………………………………………………...…………………………….…………. $

 

 

3.

 

Other receipts (explain) (

 

 

 

 

 

 

 

 

 

 

 

 

) $

 

 

4.

 

TOTAL REVENUE (add items 1 through 3)

……………………………………………………………...….. $

 

 

B. EXPENSES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

 

Cash prizes (Schedule 2, part A, TOTAL plus schedule 2, part C, TOTAL CASH DOOR PRIZES)

………………… $

 

 

2.

 

Fee paid to Treasurer, State of Connecticut (Schedule 3, line 5)

Check Number

 

…………… $

 

 

3.

 

Other expenses and/or Goodwill Payments (actually paid)

 

 

 

 

 

 

 

 

 

 

 

 

 

CHECK NO.

 

NAME OF PAYEE

 

 

DESCRIPTION

 

 

AMOUNT

 

 

 

a.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

c.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

d.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total other expenses (add items a through d)

………..……………………………………………….…………. $

 

 

4.

 

TOTAL EXPENSES (add items 1 through 3)

…………….……………………………………………………… $

 

 

C. NET PROFIT (LOSS)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

 

Net Profit (Loss) (from Part A, Line 4, TOTAL REVENUE, deduct Part B, line 4, TOTAL EXPENSES) ……………… $

 

 

STARTING CASH BANK

$

DEPOSIT MADE BY

PIN #

AMOUNT OF DEPOSIT

$

DATE OF DEPOSIT

SCHEDULE 2. LIST OF PRIZES

A. SUMMARY OF CASH BINGO GAME PRIZES

B. SPECIAL GRAND PRIZE #1 (PROGRESSIVE)

 

PRIZE

 

NO. OF GAMES

 

TOTALS

 

 

WTA #1

 

 

$

*

 

 

 

WTA #2

 

 

$

*

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

 

Amount of Special Grand

$

 

 

 

 

Prize #1 for this session

 

 

 

 

 

 

 

 

 

Amount of Special Grand

$

 

 

 

 

Prize #2 for this session

 

 

 

 

 

 

 

 

 

Breakage

 

 

$

 

 

 

 

TOTAL

 

 

$

 

 

 

*Amount awarded after 10% has been deducted

 

C. DOOR PRIZE(S)

 

 

 

 

 

MERCHANDISE DOOR PRIZE SECTION

 

 

 

DESCRIPTION

 

VALUE

 

 

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

$

 

 

 

TOTAL MERCHANDISE DOOR PRIZE(S)

 

$

 

 

 

 

CASH DOOR PRIZE SECTION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL CASH DOOR PRIZE (S)

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SCHEDULE 3. CALCULATION OF FEE

 

1.

Total bingo game receipts

 

$

 

 

(schedule 1, part A, line 1)

 

 

 

 

 

 

 

 

2.

Total cash bingo game prizes

 

$

 

 

(schedule 2, part A, Total)

 

 

 

 

 

 

 

 

3.

Total merchandise bingo game

 

$

 

 

prizes (schedule 5, Grand Total)

 

 

 

 

 

 

 

 

4.

Net receipts (deduct lines 2 and 3 from

$

 

 

 

line 1)

 

 

 

 

 

 

5.

Total fee due Treasurer, State of

 

$

 

 

Connecticut (multiply line 4 by .05)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SESSION DATE

 

AMOUNT

Week #1

 

$

 

Week #2

 

$

 

Week #3

 

$

 

Week #4

 

$

 

Week #5

 

$

 

Week #6

 

$

 

Week #7

 

$

 

Week #8

 

$

 

Week #9

 

$

 

Week #10

 

$

 

Week #11

 

$

 

Week #12

 

$

 

Week #13

 

$

 

Week #14

 

$

 

Week #15

 

$

 

Week #16

 

$

 

TOTAL PAID FOR SPECIAL GRAND PRIZE #1

$

 

D. SPECIAL GRAND PRIZE #2 (PROGRESSIVE)

 

 

SESSION DATE

 

AMOUNT

Week #1

 

$

 

Week #2

 

$

 

Week #3

 

$

 

Week #4

 

$

 

Week #5

 

$

 

Week #6

 

$

 

Week #7

 

$

 

Week #8

 

$

 

Week #9

 

$

 

Week #10

 

$

 

Week #11

 

$

 

Week #12

 

$

 

Week #13

 

$

 

Week #14

 

$

 

Week #15

 

$

 

Week #16

 

$

 

TOTAL PAID FOR SPECIAL GRAND PRIZE #2

$

 

LIST WINNER(S) FOR SPECIAL GRAND PRIZE(S):

CHECK NO.

 

NAME OF PAYEE

 

AMOUNT

 

 

 

 

$

 

 

 

 

$

 

 

 

 

$

 

 

 

 

$

 

 

 

 

$

SCHEDULE 4. DISPOSITION OF, AND ACCOUNTING FOR NET PROFIT (Contribution/Donation)

1.

2.

DATE

CHECK NO.

NAME OF PAYEE

DESCRIPTION

AMOUNT

 

 

 

TOTAL DISBURSEMENTS

$

 

 

 

I DO HEREBY MAKE OATH THAT THE STATEMENT IN THE FOREGOING REPORT IS,

FOR OFFICE

TO THE BEST OF MY KNOWLEDGE AND BELIEF, TRUE AND ACCURATE.

USE ONLY

SIGNATURE OF MEMBER-IN-CHARGE/DESIGNEE OF BINGO SESSION

PIN #

DATE

Check Number

 

 

 

 

SIGNATURE OF RANKING OFFICER

PIN #

DATE

 

 

 

 

Amount

FORM PREPARED BY (Please Print)

PIN #

TELEPHONE NUMBER

$

 

 

 

 

 

 

 

STATE OF CONNECTICUT

TEN DAY BINGO REPORT

DEPARTMENT OF CONSUMER PROTECTION

CGF-1 Merchandise Form Rev. 8/11

License Services/Charitable Games

 

 

165 Capitol Avenue

 

 

Hartford, CT 06106

 

 

E-mail: DCP.GamingCharitable@CT.gov

 

 

Web site: www.ct.gov/dcp

 

 

 

PERMIT NUMBER

 

NAME OF ORGANIZATION

DATE OF SESSION

ADDRESS (No. and Street)(City or Town)(State)(Zip Code)

SCHEDULE 5. MERCHANDISE BINGO GAME PRIZES

GAME

DESCRIPTION OF PRIZE(S)

VALUE OF PRIZE(S)

NUMBER

 

 

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

TOTAL page 1

$

 

 

 

GAME

DESCRIPTION OF PRIZE(S)

VALUE OF PRIZE(S)

NUMBER

 

 

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

TOTAL page 2

$

 

 

 

 

TOTAL page 1

$

 

 

 

 

GRAND TOTAL

$

 

 

 

How to Edit Form Cgf 1 Online for Free

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This PDF form requires particular data to be filled in, thus make sure to take whatever time to type in precisely what is asked:

1. The FOREGOING will require particular details to be typed in. Ensure that the subsequent blanks are filled out:

Writing segment 1 in WTA

2. Once your current task is complete, take the next step – fill out all of these fields - NUMBER OF CARDS, PRICE, GAME, RECEIPTS Total bingo game, B EXPENSES Cash prizes Schedule, Check Number, DESCRIPTION, CHECK NO, NAME OF PAYEE, a b c d, and AMOUNT with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

NUMBER OF CARDS, DESCRIPTION, and B EXPENSES  Cash prizes Schedule inside WTA

3. Throughout this stage, examine Total other expenses add items a, C NET PROFIT LOSS Net Profit Loss, STARTING CASH BANK, DEPOSIT MADE BY, PIN, AMOUNT OF DEPOSIT, and DATE OF DEPOSIT. These will need to be filled out with utmost awareness of detail.

Tips to fill in WTA stage 3

Be extremely mindful while filling in PIN and DATE OF DEPOSIT, since this is where a lot of people make mistakes.

4. The next section comes with all of the following blanks to focus on: Week Week Week Week Week Week, Week Week Week Week Week Week, TOTAL PAID FOR SPECIAL GRAND PRIZE, D SPECIAL GRAND PRIZE PROGRESSIVE, SESSION DATE, AMOUNT, A SUMMARY OF CASH BINGO GAME PRIZES, NO OF GAMES, TOTALS, B SPECIAL GRAND PRIZE PROGRESSIVE, SESSION DATE, AMOUNT, PRIZE WTA WTA, Amount of Special Grand Prize for, and Breakage TOTAL.

Find out how to prepare WTA part 4

5. The last point to submit this document is pivotal. Ensure you fill in the appropriate blank fields, such as Week Week Week Week Week Week, CASH DOOR PRIZE SECTION, TOTAL MERCHANDISE DOOR PRIZES, TOTAL CASH DOOR PRIZE S, SCHEDULE CALCULATION OF FEE, Total bingo game receipts schedule, TOTAL PAID FOR SPECIAL GRAND PRIZE, LIST WINNERS FOR SPECIAL GRAND, NAME OF PAYEE, AMOUNT, SCHEDULE DISPOSITION OF AND, DATE, CHECK NO, NAME OF PAYEE, and DESCRIPTION, prior to submitting. Failing to do so could produce a flawed and potentially invalid form!

WTA writing process clarified (portion 5)

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