Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 4, 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

Rockenbach, Tina

Office Address (Street, Box, or Route)

211 N. 14th Street

Permanent Residence (Street, Box, or Route)

1112 Forest Avenue

City

Lincoln

State

Zip

68508

City

Crete

State

Zip

68333

Office Phone

(402) 471-3714, Ext. 1

Home Phone

(402) 433-5120

Email Address

director@canhelp.org

PRINCIPAL {49-1480(2)}

Name

Community Action of Nebraska

Office Phone

(402) 471-3714

Office Address (Street, Box, or Route)

211 N. 14th Street

Official to Whom Lobbyist is Accountable

Karen Eisenbarth, Board President

City

Lincoln

State

Zip

68508

Nature of Business {49-1480(3)}

Human Services Non-Profit State Association

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

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Matters related to funding, programs and services for poverty, underserved populations and equity

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

Names and addresses of principal's officers:

Karen Eisenbarth, President 2022-24, Chadron, NE
Betsy Vidlak, Vice President 2022-24, Gering, NE
Jamie Swartz, Treasurer, 2022-24, Fairbury, NE
Amy Munderloh, Secretary, 2022-24, Pender, NE

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.

Tina Rockenbach

Lobbyist Name

Dec 4, 2023

Date