Form 35a - Nebraska Lottery By Pickle Card Annual Report

Instructions

Part A — Sale of Pickle Cards

Part A is to be utilized by the organization to account for all pickle card units (including punchboards) sold by the organization or sold to pickle card

operators. This includes individual pickle cards and punchboard chances sold by the organization. The organization may supply this information

in its own format, provided all of the information required by Part A is included.

Column A. Enter the total number of pickle card units (including punchboards) sold to each pickle card operator and/or sold by the organization.

A pickle card unit is a series or a complete set of pickle cards, which consists of all winning and losing cards in a particular unit, set, series, deal,

or scheme, and which also have the same serial number.

Column B. Enter the total gross proceeds from the sale of pickle card units (including punchboards) sold to each pickle card operator and/or sold

by the organization. The gross proceeds of a pickle card unit or punchboard is the total possible receipts from the sale of all pickle cards in a pickle

card unit or the total possible receipts from the sale of all punches in a punchboard.

Column C. Enter the total possible prize payouts from the pickle card units (including punchboards) indicated in column A (this information is

identified on the prize payout slip supplied by the manufacturer).

Column D. Enter the definite profit from the sale of pickle card units (including punchboards). Subtract column C from column B and enter the difference.

Column E. Enter the total amount of commissions from sales invoices for each pickle card operator selling pickle card units (including punchboards)

on behalf of the organization.

Column F. Enter the total amounts received from each pickle card operator for the pickle card units (including punchboards).

Part B — Calculation of Number of Pickle Card Units Sold,

Corresponding Gross Proceeds, and Definite Profit

Part B is to be utilized by the organization to determine the number of pickle card units (including punchboards) sold during the reporting period

and the corresponding gross proceeds and definite profit.

Line 2, Columns G, H, and I. Enter the total number of units, gross proceeds and definite profit of pickle card units (including punchboards)

on hand as of July 1 from your previous annual report or such other beginning date of the period covered by the report. Pickle card units and

punchboards still in play are considered inventory on hand. A complete physical inventory must be taken. Do not use estimates or projections.

Attach a list or use the space provided below to list your beginning inventory.

Line 3, Columns G, H, and I. Enter the total number of units, gross proceeds, and definite profit of pickle card units (including punchboards)

purchased by the organization during the period covered by the report.

Line 5, Columns G, H, and I. Enter the total number of units, gross proceeds and definite profit of pickle card units (including punchboards) on

hand as of the end of the period covered by the report. Pickle card units and punchboards still in play are considered inventory on hand. A complete

physical inventory must be taken. Do not use estimates or projections.

Attach a list or use the space provided below to list the ending inventory.

Line 6. Subtract line 5 from line 4 in columns G, H, and I. These amounts must equal the amounts in line 1, columns A, B, and D, respectively.

BEGINNING INVENTORY LISTING AS OF JULY 1, 2012 (INCLUDE UNITS IN PLAY)

Form

Number

Name of Pickle Card

Serial Number(s)

Gross Proceeds

Definite Profit

Number

of Units

and Price (i.e., $.10, $.25,$.50, $1.00)

Total (enter on line 2, columns G, H, and I) ............................................

ENDING INVENTORY LISTING AS OF JUNE 30, 2013 (INCLUDE UNITS IN PLAY)

Name of Pickle Card

Form

Number

Serial Number(s)

Definite Profit

Gross Proceeds

and Price (i.e., $.10, $.25, $.50, $1.00)

Number

of Units

Total (enter on line 5, columns G, H, and I) ............................................

Form 35a - Nebraska Lottery By Pickle Card Annual Report - 2012-2013 Page 9

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