Form 35b - Nebraska Lottery/raf E Annual Report - 2012-2013 (Page 7 of 7) in pdf

NEBRASKA SCHEDULE II — Summary of Lottery/Raffle Activity

FORM 35B

• Attach this page to Form 35B (page 1).

Schedule II

• Include all lottery/raffles where drawings occurred between July 1, 2012 and June 30, 2013.

Page 3

Organization's Name on Form 35B

Nebraska ID Number

35 —

No. of

(B)

DATES OF LOTTERY/RAFFLE

(A)

Tickets Sold

PRIZES AWARDED

Cost Per

Gross Proceeds

Including

Single Ticket

Check

Merchandise

Beginning

Ending

Free Tickets

Cash

1 Total gross proceeds . . . . . . . . . . . . . . . . . . . . . . 1

2 Less amount applicable to free/discounted tickets 2

3 Adjusted gross proceeds (line 1 minus line 2) . . . 3

4 Total prizes awarded . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5 Less value of donated prizes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6 Adjusted prizes (line 4 minus line 5) . . . . . . . . . . . . . . . . . . . . . . . . . . .

Instructions

The summary of lottery/raffle activity must reflect each lottery with gross proceeds exceeding $1,000 and each raffle with gross

proceeds exceeding $5,000.

The summary of lottery/raffle activity should include only lottery/raffle(s) where the drawing (ending date) took place

between July 1, 2012 and June 30, 2013. The beginning date for lottery/raffle ticket sales may have been prior to July 1, 2012.

Gross proceeds for each lottery/raffle includes the total receipts from the conduct of the lottery or raffle, including any required

admission costs, other required purchases, and the value of any free tickets given to players with no reduction for discounts. For

example, if a discount is offered for the purchase of multiple tickets, such as six tickets for five dollars instead of one dollar per

ticket (the cost of a single ticket) the six tickets must be valued at one dollar each for purposes of calculating gross proceeds.

Cash, checks or merchandise prizes awarded for each lottery/raffle include the fair market value (selling price) of any prizes which

were donated to the organization.

Prizes awarded should reflect all prizes related to the drawings included on this report, even though some prizes may not have

been paid or claimed during the reporting period.

Form 35b - Nebraska Lottery/raf E Annual Report - 2012-2013 Page 7