Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Nov 20, 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

Loontjer, Pat

Office Address (Street, Box, or Route)

12213 Westwood Lane

Permanent Residence (Street, Box, or Route)

City

Omaha

State

Zip

68144

City

State

Zip

Office Phone

(402) 598-7227

Home Phone

(402) 598-7227

Email Address

ploontjer@aol.com

PRINCIPAL {49-1480(2)}

Name

Gambling with the Good Life

Office Phone

(402) 598-7227

Office Address (Street, Box, or Route)

1065 N. 115th Street, Suite 100

Official to Whom Lobbyist is Accountable

City

Omaha

State

Zip

68154

Nature of Business {49-1480(3)}

Stop expanded gambling

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)} Expanded Gambling

Description of industry, trade, profession, or interests and groups represented by the principal:
Keep Nebraska safe from expanded gambling

Names and addresses of principal's officers:

Dave Wimmer - 1231 E. Grove St. West Point, NE 68788 - President
Daniel J. Hazuka - 4317 So. 179 St. Omaha, NE 68135 - Treasurer

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)}

NONE

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

Pat Loontjer

Lobbyist Name

Nov 20, 2023

Date