QID Indiana Off Track Betting Survey - 2010

Indiana Off Track Betting Survey			OMB No. 0535-0227 Approval Expires: 03/31/2014 Project Code: 451 QID:
				NATIONAL AGRICULTURAL STATISTICS SERVICE

						U.S. Department of Agriculture NOC Division 9700 Page Avenue, Suite 400 St. Louis, MO 63132-1547 Phone: 1-888-424-7828 FAX: 314-595-9990 [email protected]
Please make corrections to name, address and ZIP Code, if necessary. The information you provide will be used for statistical purposes only. In accordance with the Confidential Information Protection provisions of Title V, Subtitle A, Public Law 107-347 and other applicable Federal laws, your responses will be kept confidential and will not be disclosed in identifiable form to anyone other than employees or agents. By law, every employee and agent has taken an oath and is subject to a jail term, a fine, or both if he or she willfully discloses ANY identifiable information about you or your operation. Response is voluntary. According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0535-0227. The time required to complete this information collection is estimated to average 20 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

1. Do you represent an Off Track Betting or simulcast facility in the Indiana?

 Yes  No – Do not answer survey

2. Please indicate the location of the facility.

State ______________________________ County ____________________________

3. Please indicate the REVENUE in 2009 from the following sources:

   1. Admissions $_______________________

   2. Concessions $_______________________

   3. Parking $_______________________

   4. Programs $_______________________

   5. All other revenue (includes gross earned on handle, surcharges, capital improvement surcharge, breakage, uncashed pari-mutuel tickers, and interest income) $_______________________

4. Please indicate the EXPENSES in 2009 on the following items:

General Operating Expenses:

1. Facilities Maintenance $________________________

2. Equipment, and Vehicle Maintenance $________________________

3. Equipment and Vehicle Rental $________________________

4. Salaries, Wages, and Benefits $________________________

5. Advertising Expenses $________________________

6. Insurance Expenses $________________________

7. Equipment Purchases $________________________

8. Utility Expenses $________________________

9. Office Supplies Expenses $________________________

10. All other expenses(including revenue allocated to the racing industry in 2009, all track commissions and contributions to breed and development funds) $______________________

11. Total Breakage in 2009 $________________________

12. Total un-cashed parimutual tickets $________________________

Taxes

13. Parimutual Taxes $________________________

14. Admission Taxes $________________________

15. Federal Taxes $________________________

16. State Taxes $________________________

17. Local Taxes $________________________

1. Does your OTB outlet have assets that it owns?

 Yes  No

Please estimate the total value of assets owned by your OTB as of December 31, 2009. Only include assets that relate to the production and/or delivery of goods and services in the horse industry in the Indiana.

6. What is the fair market value of equipment and structures owned by your OTB? $__________________

7. What is the estimated fair market value of land owned by your OTB? $__________________

8. Did your OTB make any capital investments in 2009? $__________________

 Yes  NO

9. In 2009, what was your OTB’s total capital investment in equipment and structures? $________________

10. In 2009, what was your OTB’s total capital investment in Land(purchase price) $___________________

11. Did your OTB employ any personnel in 2009?

 Yes  No

12. During a typical month in 2009, what was the number of full time, full-year employees on your payroll? __________

13. During a typical month in 2009, what was the number of seasonal employees that were on your payroll and the average number of weeks worked per seasonal employee?

    1. Number of seasonal employees _______________

    2. Average number of weeks worked by seasonal employees _______________

14. During a typical month in 2009, what was the number of part-time employees on your payroll? _______________

15. What was the average number of weeks worked by part time employees in 2009? ________________________

16. What was the average number of hours worked by a single part-time employee in a week __________________

17. Does your OTB utilize electronic wagering technology? (off track betting technology that allows for wagering by way of cable, hone, wire, or any other technology other than the Internet that is remote from the racetrack site)

 Yes  No

What percentage of your total revenue is received through electronic wagering? ______%

18. Does your racetrack have electronic gaming machines? (Slot machines, video lottery terminals, video poker, instant racing, electronic pull-tabs, electronic keno or any other video based electronic gaming machines)

 Yes  No

19. What percentage of your total revenue is generated from electronic gaming machines? _________%

20. Does your racetrack conduct wagering over the Internet? (off track betting technology t hat allows for wagering through the Internet or closed loop online system by way of personal computer or hand held device).

 Yes  No

21. Approximately what percentage of your total revenue is generated via the Internet? __________________%

Thank you please return your survey in the enclosed postage paid envelope.

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