Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 1, 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

Brunkhorst, Kelly

Office Address (Street, Box, or Route)

245 Fallbrook Blvd., Suite 204

Permanent Residence (Street, Box, or Route)

2111 Herel St.

City

Lincoln

State

Zip

68521

City

Lincoln

State

Zip

68512

Office Phone

(402) 438-6459

Home Phone

(402) 419-3373

Email Address

kbrunkhorst@necga.org

PRINCIPAL {49-1480(2)}

Name

Nebraska Corn Growers Association

Office Phone

(402) 438-6459

Office Address (Street, Box, or Route)

245 Fallbrook Blvd., Suite 204

Official to Whom Lobbyist is Accountable

President of NeCGA

City

Lincoln

State

Zip

68521

Nature of Business {49-1480(3)}

Corn Industry

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 Year

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} All issues relating to agriculture

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

Names and addresses of principal's officers:

4435 O Street, Suite 210
Lincoln, NE 68510

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.

Kelly Brunkhorst

Lobbyist Name

Dec 1, 2023

Date