Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Nov 15, 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

Smith, Jim

Office Address (Street, Box, or Route)

6910 Pacific Street, Suite 216

Permanent Residence (Street, Box, or Route)

City

Omaha

State

Zip

68106

City

State

Zip

Office Phone

(402) 452-3737

Home Phone

Email Address

jsmith@platteinstitute.org

PRINCIPAL {49-1480(2)}

Name

Platte Institute for Economic Research

Office Phone

(402) 452-3737

Office Address (Street, Box, or Route)

6910 Pacific Street, Suite 216

Official to Whom Lobbyist is Accountable

City

Omaha

State

Zip

68106

Nature of Business {49-1480(3)}

Policy Research

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 Per Month

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

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

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: {49-1480(8)}

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

Jim Smith

Lobbyist Name

Nov 15, 2023

Date