Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Oct 24, 2023

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

Bennett, Amy

Office Address (Street, Box, or Route)

211 E. Fonner Park Road

Permanent Residence (Street, Box, or Route)

211

City

Grand Island

State

Zip

68801

City

Grand Island

State

Zip

68801

Office Phone

(308) 384-9922

Home Phone

(308) 850-8443

Email Address

abennett@ywca-gi.org

PRINCIPAL {49-1480(2)}

Name

Young Woman's Christian Association of Grand Island, NE Inc.

Office Phone

(308) 384-9922

Office Address (Street, Box, or Route)

211 E Fonner Park Rd

Official to Whom Lobbyist is Accountable

Board of Directors

City

Grand Island

State

Zip

68801

Nature of Business {49-1480(3)}

Nonprofit providing childcare and human services

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

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} childcare, early education, human service issues, women's issues, issues effecting families, social justice, economic development, housing, education

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

Names and addresses of principal's officers:

Kelli Mayhew, Board Chair, 123 S Webb Rd, Grand Island, NE 68803

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.

Amy Bennett

Lobbyist Name

Oct 24, 2023

Date