U.S. DOD Form dod-af-af-2046
NAFI BINGO ACTIVITY REPORT
SHEET NUMBER
DATE
LOCATION
NAFI/ACTIVITY
(This form is subject to the Privacy Act of 1974-See reverse)
GAME
PRIZE
DESCRIPTION
ITEM NO
WINNER
COST
COST
PRINT NAME AND SSAN
SIGNATURE & MBR CARD NO.
ADDRESS (Include ZIP Code)
TOTAL
TICKETS
A
B
ENDING NUMBER
BEGINNING NUMBER
NUMBER SOLD
PRICE
C
D
.
E
INCOME/COSTS
RECEIPTS
COST OF PRIZE(S)
CASH PRlZE(S)
TOTAL COST OF PRlZE(S)
RECEIPTS
GROSS PROFIT
CERTIFIED BY
LABOR
NET INCOME
FORM
AF JUL 76 2046
PREVIOUS EDITION IS OBSOLETE
PRIVACY ACT STATEMENT
AUTHORITY: 10 USC 8012; 44 USC 3101; and EO 9397.
PRINCIPAL PURPOSE(S): To record all social recreation and open mess bingo prize disbursements, to establish ticket accountability, and to record receipts.
ROUTINE USES: To account for all bingo prize disbursements for each bingo event, to reflect ticket sales by price of ticket, and to record receipts. Informa­
tion fournished may be disclosed to any DOD component or part thereof, and upon request, to other federal, state, and local governmental agencies in the
pursuit of their official duties; disclosed to news media announcing winners; and used for other lawful purposes including law enforcement and litigation. The
SSAN is used for identification of the individual and records.
DISCLOSURE IS VOLUNTARY :Failure to provide the infomation and SSAN may preclude the individual from receiving the bingo prize.