The statement must contain the following information for each charity casino:(1) the number of admission tickets on sale;
(2) the number of admission tickets sold;
(3) the selling price of an admission ticket;
(4) the gross revenues from the sale of admission tickets;
(5) the gross revenues from the sale of additional phoney money;
(6) the total value of prizes awarded;
(7) the actual cost of each prize awarded, as well as supporting vouchers at the board’s request;
(8) the total value of the prizes claimed;
(9) the administration expenses;
(10) the profit or loss;
(11) the name and address of each winner of a prize valued at $2,000 or more, at the board’s request;
(12) an attestation that all prizes offered were awarded or the reasons why they were not awarded.