Form 35a - Nebraska Lottery By Pickle Card Annual Report

Instructions

When and Where to File. The annual report for the period July 1, 2012 to June 30, 2013 must be filed with

the Nebraska Department of Revenue (Department) by August 15, 2013. If the organization's current license

expires September 30, 2013 and it does not intend to renew its license, it must also file a final report for the period

July 1, 2013 to September 30, 2013 within 45 days of the expiration date of the license. That final report should

reflect three months of pickle card activity and the final distribution of all pickle card profits or a plan for the

disbursement of any remaining funds. The organization must continue to submit pickle card revenue status reports

each year by August 15 until all pickle card profits have been disbursed for lawful purposes.

If the organization does not intend to renew its license, has completed all pickle card activity by June 30

of any year, and has disbursed all of its pickle card profits for lawful purposes, write “Final Report” at the

top of the report.

Reporting Period. The annual report is to cover the organization’s lottery by the sale of pickle card activities

from July 1 through June 30. If the organization is filing a short period report, the beginning and ending dates of

the reporting period must be entered in the space provided at the top of the report. If all profits from the conduct

of lottery by pickle card have been disbursed during this reporting period and no further pickle card activity is

anticipated, write “Final Report” at the top of page 1.

Accounting Method. The annual report is to be prepared based upon the organization’s accounting basis: cash;

accrual; or other.

Specific Instructions

Line 1. Enter the gross proceeds derived from the conduct of a lottery by the sale of pickle cards. Gross proceeds

are defined as the total possible receipts from the sale of all pickle cards in any pickle card unit and from the sale

of all punches in a punchboard. Enter amount from Nebraska Schedule II (page 3), column B, line 1.

Line 2. Enter the amount of prizes paid from the conduct of a lottery by the sale of pickle cards. Prizes paid is

the total possible prize payout for each unit of pickle cards sold or for each punchboard sold. Enter amount from

Nebraska Schedule II (page 3), column C, line 1.

Line 4. Enter the commissions allowed to pickle card operators who sell individual pickle cards on behalf of the

organization. Enter amount from Nebraska Schedule II (page 3), column E, line 1.

Line 6. Enter the net amount of any adjustments to income which either increase or decrease the gross profit

reported on line 5. Increasing adjustments to income include any interest income earned attributable to any lottery

by pickle card bank account, including savings accounts and certificates of deposit, rental income from pickle card

dispensing devices, deposit overages, and any other income derived from the conduct of the lottery by the sale of

pickle cards. Decreasing adjustments to income include deposit shortages or losses experienced in the conduct

of the lottery by the sale of pickle cards (stolen pickle cards, fire loss, etc.). Attach an itemized list to the annual

report identifying the nature of each adjustment and the corresponding amount.

Line 8. Enter the total invoice cost of pickle card units purchased from distributors, including state pickle card tax.

Line 9. Enter the total amount paid for federal taxes and federal fees levied against pickle card income

or activities.

Line 10. Enter the gross compensation paid to employees or officers for services performed which relate to the

conduct of the lottery by the sale of pickle cards. Wages paid to employees selling pickle cards at the organization’s

bingo occasion should be reported on the Nebraska Bingo Annual Reports, Form 35 or 35C (page 1), and must be

paid out of the bingo checking account.

Line 11. Enter the commissions or salaries paid to sales agents for the selling of pickle card units or punchboards

to pickle card operators on behalf of the organization.

Line 12. Enter the amount paid for the lease or rental of any equipment, including pickle card dispensing devices

utilized in conjunction with the conduct of the lottery by the sale of pickle cards.

Form 35a - Nebraska Lottery By Pickle Card Annual Report - 2012-2013 Page 4

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