(B) Each machine owner, operator, or licensed establishment must establish and implement cash controls and shall report to the department on a quarterly basis the following information for each machine:

1. (1) name and address of location of the machine;
2. (2) denomination, whether five cents, twenty-five cents, etc., of game;
3. (3) the name of the game;
4. (4) the name of the individual collecting money from the machine or the owner of the machine;
5. (5) the date of collection;
6. (6) the date of previous collection;
7. (7) income number at commencement of reporting period;
8. (8) income number at the end of the reporting period;
9. (9) beginning payout number;
10. (10) ending payout number;
11. (11) payout to players;
12. (12) gross profit;

13. (13) the percentage of net profits divided between owner and location.

    This report must be filed with the department by the twentieth of the month following the end of the calendar quarter.