Form 51B Schedule I "Bingo Occasion Activity Report" - Nebraska

What Is Form 51B Schedule I?

This is a legal form that was released by the Nebraska Department of Revenue - a government authority operating within Nebraska.The document is a supplement to Form 51B, Nebraska Bingo Tax Return. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2011;
  • The latest edition provided by the Nebraska Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 51B Schedule I by clicking the link below or browse more documents and templates provided by the Nebraska Department of Revenue.

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Download Form 51B Schedule I "Bingo Occasion Activity Report" - Nebraska

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RESET FORM
I
NEBRASKA SCHEDULE
— Bingo Occasion Activity Report
FORM 51B
Schedule I
Attach to Form 51B.
Nebraska ID Number
Tax Period
Name as Shown on Form 51B
(A)
(B)
(C)
(D)
(E)
Check (✓)
Occasion Date
Bingo
Bingo
Number
Bingo Occasion
Bingo Occasion
Type of Occasion
Gross Receipts
Prizes
of Players
Promotional Prizes
Pickle Card Sales
No. Mo. Day Year Regular Limited
$
$
$
$
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
$
5 Total bingo gross receipts (enter
Column A amount on line 1,
00
Form 51B). . . . . . . . . . . . . . . . . . . . . . .
5
$
$
$
00
00
00
Totals for Columns B, C, D, and E . . . . . . . . . . . . . . . . . . . . . . . . . . . .
RETAIN A COPY FOR YOUR RECORDS.
6-2011
9-019-1987 Rev.
Supersedes 9-019-1987 Rev. 5-2009
RESET FORM
I
NEBRASKA SCHEDULE
— Bingo Occasion Activity Report
FORM 51B
Schedule I
Attach to Form 51B.
Nebraska ID Number
Tax Period
Name as Shown on Form 51B
(A)
(B)
(C)
(D)
(E)
Check (✓)
Occasion Date
Bingo
Bingo
Number
Bingo Occasion
Bingo Occasion
Type of Occasion
Gross Receipts
Prizes
of Players
Promotional Prizes
Pickle Card Sales
No. Mo. Day Year Regular Limited
$
$
$
$
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
$
5 Total bingo gross receipts (enter
Column A amount on line 1,
00
Form 51B). . . . . . . . . . . . . . . . . . . . . . .
5
$
$
$
00
00
00
Totals for Columns B, C, D, and E . . . . . . . . . . . . . . . . . . . . . . . . . . . .
RETAIN A COPY FOR YOUR RECORDS.
6-2011
9-019-1987 Rev.
Supersedes 9-019-1987 Rev. 5-2009
INSTRUCTIONS
WHO MUST FILE. Every nonprofit organization, volunteer fire company, or volunteer first-aid, rescue,
ambulance, or emergency squad licensed to conduct bingo must file the Nebraska Schedule I – Bingo Activity
Report. A report is required for every tax period, or portion of a tax portion, an organization is licensed to conduct
bingo, even if there was no bingo activity.
WHEN AND WHERE TO FILE. This report must accompany the organization’s Nebraska Bingo Tax Return,
Form 51B, which is to be filed with the Nebraska Department of Revenue (Department) on or before the 30th
day of the month following the tax period covered by the return.
VERIFICATION AND AUDIT. Records to substantiate this report must be kept available for three years
following the filing date of the report.
SPECIFIC INSTRUCTIONS
TYPE OF OCCASION. Place a check mark in the “Regular” column if the occasion was a regular bingo
occasion, or in the “Limited” column if the occasion was a limited period bingo occasion.
COLUMN A. Enter the gross receipts from the bingo occasion. Gross receipts include admission charges, the
sale or rental of regular and special bingo cards and instant bingo cards, any fee charged for the use of bingo card
monitoring devices, and the value of in-kind payments.
COLUMN B. Enter the total value of bingo prizes awarded at the occasion. Include cash prizes, whether paid in
cash or by check, the fair market value of merchandise prizes, and the fair market value of donated prizes which
were awarded for winning bingo games.
COLUMN D. Enter the total fair market value of all promotional prizes awarded at the bingo occasion (door
prizes or other prizes awarded for reasons other than directly winning a bingo game).
COLUMN E. Enter total pickle card sales at bingo occasion without reduction for prizes paid out. All
organizations which transfer funds from the pickle card checking account to the bingo checking account must
complete column E.
Any questions regarding the completion of the Nebraska Schedule I – Bingo Occasion Activity Report should
be addressed to the Nebraska Department of Revenue, Charitable Gaming Division, PO Box 94855, Lincoln,
NE 68509-4855, 402-471-5937, or 877-564-1315. Additional information and forms may be obtained at
revenue.nebraska.gov/gaming.
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