Nebraska Legislature - Lobbyist Reporting Application

NEBRASKA LEGISLATURE

LOBBYIST REGISTRATION RECORD

Nov 19, 2013

Clerk of the Legislature
Room 2014, State Capitol
PO Box 94604
Lincoln, NE 68509-4604
Phone: (402) 471-2608

For Calendar Year of:

Amended Registration

Lobbyist Registration Fee:
{49-1480.01}

Compensated

$200.00

(If you are a salaried employee of your principal, you are a compensated lobbyist.)

Not Compensated

$15.00

(File a Form E for quarterly report exemption. You are not exempt from the Form D Activity Report.)

PLEASE FILL IN ALL BLANKS

LOBBYIST {49-1480(1)}

Name

Loontjer, Pat

Office Address (Street, Box, or Route)

2221 S. 141st Court, #6

Permanent Residence (Street, Box, or Route)

City

Omaha

State

Zip

68144

City

State

Zip

Office Phone

(402) 551-2776

Home Phone

(402) 598-7227

Email Address

ploontjer@aol.com

PRINCIPAL {49-1480(2)}

Name

Gambling with the Good Life

Office Phone

(402) 493-4495

Office Address (Street, Box, or Route)

1065 N. 115th Street, Suite 100

Official to Whom Lobbyist is Accountable

Board of Directors

City

Omaha

State

Zip

68154

Nature of Business {49-1480(3)}

GAMBLING

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
2,000.00 Per Month

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Gambling

Description of industry, trade, profession, or interests and groups represented by the principal:
Anti-gambling