Form 51a - Nebraska Schedule I - Distributor Activity Report
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NEBRASKA SCHEDULE I — Distributor Activity Report
• Read instructions on reverse side
51A
RESET FORM
• Attach to Form 51A
Name as Shown on Form 51A
Nebraska Identification Number
Tax Period
SUMMARY OF SALES — LICENSED ORGANIZATION
(A)
(B)
(C)
Number of
Name
State Identification Number
Gross Proceeds
Definite Profit
Units
$
$
7 Totals from other Nebraska Schedule I, Form 51A .........................
7
8 Total number of units (enter column A amount on line 1, Form 51A) ...
8
9 Total gross proceeds (enter column B amount on line 2, Form 51A) ...............
9 $
.00
10 Total definite profit (enter column C amount on line 3, Form 51A) ...................................................... 10 $
.00
INVENTORY OF PICKLE CARD UNITS
11 Beginning inventory (must match ending inventory last tax period) ................. 11
12 Net units purchased from all manufacturers..................................................... 12
13 Total of line 11 and line 12 .................................................................................................................. 13
14 Net units sold in Nebraska ............................................................................... 14
15 Net units sold out-of-state ................................................................................ 15
16 Total number of units sold (total of line 14 and line 15) ....................................................................... 16
17 Ending inventory of units (line 13 minus line 16) .................................................................................
17
PLEASE MAKE A COPY FOR YOUR RECORDS
9-052-1988 Rev. 6-2009
Supersedes 9-052-1988 Rev. 7-2002
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Parent category: Financial