Nebraska Accountability and Disclosure Commission


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Committee Contributors Expenditures
ITEM 5 CONTRIBUTIONS OF OVER $250 RECEIVED IN A CALENDAR YEAR
List the name and street address of contributors whose total contributions in any calendar year are more than $250. If the contributor is a committee, also list the name and address of the committee treasurer. (E.g., A person who gave $150 and later in the same year gave $125 must be included). Depending on the period covered by your report (see Item 4) you may be reporting for only a portion of a calendar year.
Name and Street Address
or Rural Route of Contributor
Date of
Contributions
Total at Start
of Period
Cash
Contributions
In-Kind
Contributions
Unpaid
Pledges
Total Calendar
Year to Date
             
             
Note: No committee, or other person, shall accept or expend and anonymous contribution (see definition). If an anonymous contribution is received, it shall not knowingly be deposited but shall be given to a tax exempt charitable organization. The charitable organization receiving the contribution shall provide teh person with a receipt. (Attach receipt to this filing.)



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