FORM
A
NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST
Jan 16, 2024
Amended Registration
Lobbyist Registration Fee:
{49-1480.01}

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

1005 S. 107th Ave 

1005 S. 107th Ave 

Omaha 

NE 

68114 

Omaha 

NE 

68114 

(402) 933-0565 

(402) 933-0565 

HeartlandStrategyGroupLobby 

PRINCIPAL {49-1480(2)}

(402) 350-1679 

14504 south 23rd street 

 

bellevue 

NE 

68123 

Medical  

AMOUNTS GIVEN
0.00  Per Month  
IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Medical  
Description of industry, trade, profession, or interests and groups represented by the principal:
Medical  
Names and addresses of principal's officers:

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:

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

Heartland Strategy Group

Lobbyist Name

Jan 16, 2024

Date