Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 27, 2017

(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

Nielsen, Coleen J.

Office Address (Street, Box, or Route)

140 N. 8th Street, Suite 340

Permanent Residence (Street, Box, or Route)

3733 S. 58th Street

City

Lincoln

State

Zip

68508

City

Lincoln

State

Zip

68506

Office Phone

(402) 441-4848

Home Phone

(402) 432-9352

Email Address

coleen@brennannielsenlaw.com

PRINCIPAL {49-1480(2)}

Name

Bromm Nielsen & Mines

Office Phone

(402) 327-1603

Office Address (Street, Box, or Route)

635 S 14th Suite 315

Official to Whom Lobbyist is Accountable

City

Lincoln

State

Zip

68508

Nature of Business {49-1480(3)}

Government Relations

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

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

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

Names and addresses of principal's officers:

Curt Bromm; Jason Bromm; Coleen Nielsen and Mick Mines. 635 S 14th Suite 315. 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)}

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

Nielsen, Coleen J.

Lobbyist Name

Dec 27, 2017

Date