NEBRASKA
ACCOUNTABILITY AND
DISCLOSURE COMMISSION
1225 L St., Suite 400
P.O. Box 95086
Lincoln, NE 68509
(402) 471-2522
BEFORE COMPLETING THIS FORM READ THE FILING REQUIREMENTS ON PAGE 3 / POSTMARK
DATE
MICROFILM
NUMBER
AGENT'S EXPENDITURE REPORT
NADC Form B-10
OFFICE USE ONLY
  • No Expenditure shall be made, other than for overhead or normal operating expenses, by an agent or independent contractor, including an advertising agency, on behalf of or for the benefit of a candidate or committeeunless the expenditure is reported by the committee, or unless the agent or independent contractor files an Agent’s Expenditure Report.
  • No expenditure shall be made, other than for overhead or normal operating expenses, by an individual or an entity gathering petition signatures on behalf of anyone, including a ballot question committee, unless the expenditure is reported by the ballot question committeeas if the expenditure were made directly by the committee, or unless the person or entity gathering signatures files an Agent’s Expenditure Report.
  • An individual or entity gathering petition signatures, an agent, or an independent contractor who is required to file this report shall file a separate Agent’s Expenditure Report for each person on whose behalf an expenditure is made.
  • An Agent’s Expenditure Report shall be filed with the Commission within 10 days after the end of the calendar month in which the expenditure is made.
  • Persons who fail to file this report or otherwise comply with the reporting provisions of the law are subject to penalties.

Item 1 / NAME, ADDRESS AND PHONE NUMBER OF THE ENTITY OR INDIVIDUAL FILING THE REPORT
Name / Permanent Telephone No.
Permanent Address
STREET ADDRESS OR RURAL ROUTE / CITY / STATE / ZIP
Temporary Address
STREET ADDRESS OR RURAL ROUTE / CITY / STATE / ZIP
Temporary Telephone No.
STATE OF
COUNTY OF
I / UPON OATH, STATE THAT I AM DULY AUTHORIZED TO FILE THIS REPORT, THAT I HAVE
(Name of Individual Signing)
USED ALL REASONABLE DILIGENCE IN ITS PREPARATION AND THAT TO THE BEST OF MY KNOWLEDGE IT IS TRUE AND COMPLETE.
(SIGNATURE AND TITLE)
SUBSCRIBED AND SWORN TO BEFORE ME THIS / DAY OF / 20
(SEAL)
(NOTARY PUBLIC)
Revised January 2018
PLEASE NOTE THAT A SEPARATE AGENTS REPORT MUST BE FILED FOR EACH PERSON OR COMMITTEE ON WHOSE BEHALF AN EXPENDITURE HAS BEEN MADE
Please put below the Name, Street Address or Rural Route, City, State and Telephone Number of the Person or Committee on whose behalf the expenditure is made.
Name of Person or Committee / Street Address or Rural Route, City and State / Telephone Number
The Name, permanent Street Address or Rural Route, City and State of the person to whom expenditures were made / The Temporary Street Address or Rural Route, City and State of the person to whom the expenditure was made / Date of each Expenditure / Amount of each Expenditure / A Description of the Goods or Services Purchased.

General Information - Filing Information

  1. Who Should file:

Any agent or independent contractor, including an advertising agency, who makes expenditures on behalf of or for the benefit of a person or a committee shall file this report.

Any individual or entity who makes expenditures in connection with the gathering of petition signatures on behalf of or for the benefit of a person, including a ballot question committee, shall file this report.

An exemption applies for those expenditures that are associated with normal overhead and operating expenses. An exemption is also applicable if the committee on whose behalf the expenditures are being made will report the expenditures as if the expenditures were made directly by the committee. Individuals and entities who make expenditures on behalf of committees should be sure that there is a clear understanding with the committee as to who is going to report expenditures.

II.When to File:

Within ten days after the end of the calendar month in which the expenditure was made.

III.Where to File: With the Nebraska Accountability and Disclosure Commission, 1225 L. St., Suite 400, P.O. Box 95086, Lincoln, NE 68509

Report of earmarked contributions (NADC Form B-3): Any person, other than a committee, which acts as an intermediary or agent in transferring an earmarked contribution directly or indirectly from a contributor to the recipient candidate or political committee must report the contribution on NADC Form B-3, Report of Earmarked Contribution, within 10 days of that person's receipt of the earmarked contribution. The earmarked contribution must be transferred to the recipient candidate or committee within the same 10-day period.

A Major Out-of-State Contributor Report (NADC Form B-9): Any corporation, union or industry, trade and professional association which is not organized under the laws of the State of Nebraska which makes expenditures, contributions or provides personal services of over $10,000 in any calendar year for the purpose of influencing or attempting to influence the action of the voters for or against the nomination or election of one or more candidates or the qualification, passage or defeat of one or more ballot questions elections in the State of Nebraska.

An exemption applies to those entities who have a Statement of Organization of a Political Committee (NADC Form A-1) on file with the Commission, a person or organization required to file campaign statements with the Commission; and those entities required to file a Report of Political Contribution of a Corporation, Union or Other Association (NADC Form B-7) with the Commission. In addition, a committee or organization registered with the Federal Election Commission need not file the Out-of-State Contribution Report.

Definitions

Ballot Question means any question which is submitted or which is intended to be submitted to a popular vote at an election by way of initiative, referendum, recall, or bond issue or as a result of legislative action, whether or not it qualifies for the ballot.

Contribution means a payment, gift, subscription, assessment, expenditure, contract, payment for services, dues, advance, forbearance, loans, donation, pledge or promise of money or anything of ascertainable monetary value to a person, made for the purpose of influencing the nomination or election of a candidate, or for the qualification, passage or defeat of a ballot question. A contribution includes the purchase of tickets or payment of an attendance fee for events such as dinners, luncheons, rallies, testimonials, and similar fund raising events. It also includes the granting of discounts or rebates by broadcast media and newspapers not extended on an equal basis to all candidates for the same office.

An in-kind contribution means a contribution as defined above, other than money, i.e. goods, materials, services or other things of value furnished by your corporation, union or association to a candidate or other political committee.

A Pledge is an oral or written promise of a future payment of money or anything of ascertainable monetary value.

Earmarked means a designation, instruction, or encumbrance, including those which are direct or indirect, express or implied, or oral or written which results in any part of a contribution or expenditure, including any in-kind expenditure made in exchange for a contribution, being made to or expended on behalf of a candidate or a committee.

Election means a primary, general, special, or other election held in this state or a convention or caucus of a political party held this state to nominate a candidate. Election shall include a vote on a Ballot Question.

Expenditure means a payment, donation, loan, pledge, or promise of payment of money or anything of ascertainable monetary value for goods, materials, services or facilities in assistance of, or in opposition to, the nomination or election of a candidate, or the qualification, passage or defeat of a ballot question. Expenditure includes a contribution or transfer of anything of ascertainable monetary value for purposes of influencing the nomination or election of any candidate or the qualification, passage, or defeat of a ballot question.

An Independent Expenditure means a payment, donation, loan, pledge, or promise of payment of money or anything of ascertainable monetary value for goods, materials, services, or facilities in assistance of, or in opposition to, the nomination or election of a candidate, or the qualification, passage or defeat of a ballot question, which is not made at the direction of, under the control of, or in cooperation with another person and which is not a direct contribution to a committee or candidate.

Any expenditure which is made as a result of a request or explicit suggestion of the candidate, the committee treasurer, or anyone acting on behalf of either, shall be considered an in-kind contribution and not an independent expenditure.

Personal Services means personnel provided to or for the benefit of a candidate or ballot question or a political party committee when the person rendering such services is paid his or her regular salary or is otherwise compensated by such corporation, union or association.