Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 24, 2023

(This report is required to be filed on or before December 31 of each calendar year.)
49-1480.01(3)

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

Morfeld, Adam

Office Address (Street, Box, or Route)

530 S. 13th, Suite 100

Permanent Residence (Street, Box, or Route)

3637 Holdrege Street

City

Lincoln

State

Zip

68508

City

Lincoln

State

Zip

68503

Office Phone

(402) 904-5191

Home Phone

(402) 904-5191

Email Address

adam.morfeld@civicnebraska.org

PRINCIPAL {49-1480(2)}

Name

Civic Nebraska

Office Phone

(402) 770-5756

Office Address (Street, Box, or Route)

530 S 13th Street

Official to Whom Lobbyist is Accountable

City

Lincoln

State

Zip

68508

Nature of Business {49-1480(3)}

Civic Engagement

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

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Issues dealing with civic education and elections.

Description of industry, trade, profession, or interests and groups represented by the principal:
Non profit public interest work around elections and civics

Names and addresses of principal's officers:

Preeta Bansal, Board Chair
Cesar Garcia, Treasurer
530 S. 13th Street, Suite 100
Lincoln, NE 68508

GIVE NAME and ADDRESS of any OFFICIAL in the Legislative or Executive Branch and of any members of any such official's staff or immediate family who is employed by you or by anyone acting on your behalf: {49-1480(8)}

None

I certify that all information presented in this form is accurate to the best of my knowledge.

Adam Morfeld

Lobbyist Name

Dec 24, 2023

Date