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

Hapgood, Wade

Office Address (Street, Box, or Route)

330 NW 82nd Street

Permanent Residence (Street, Box, or Route)

330 NW 82nd Street

City

Topeka

State

Zip

66617

City

Topeka

State

Zip

66617

Office Phone

(785) 554-1061

Home Phone

Email Address

wade_hapgood@uhg.com

PRINCIPAL {49-1480(2)}

Name

United Healthcare Services, Inc.

Office Phone

(702) 242-7191

Office Address (Street, Box, or Route)

9900 Bren Road East

Official to Whom Lobbyist is Accountable

Erin Russell

City

Minnetonka

State

Zip

55343

Nature of Business {49-1480(3)}

INSURANCE

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
5,000.00 Percentage of salary

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Insurance, health and healthcare, medicaid, tax

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

Names and addresses of principal's officers:

Tarrant Jeffrey Putnam, 9900 Bren Road East, Minnetonka, MN 55343
Thomas Edward Roos, 9900 Bren Road East, Minnetonka, MN 55343
Payman Pezhman, 9900 Bren Road East, Minnetonka, MN 55343
Peter Marshall Gill, 9900 Bren Road East, Minnetonka, MN 55343
Steven Marc Burstein, 9900 Bren Road East, Minnetonka, MN 55343
Heather Anastasia Lang, 9900 Bren Road East, Minnetonka, MN 55343
Jessica Leigh Zuba, 9900 Bren Road East, Minnetonka, MN 55343
Nyle Brent Cottington, 9900 Bren Road East, Minnetonka, MN 55343

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.

Wade Hapgood

Lobbyist Name

Nov 15, 2023

Date