Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 5, 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

Spivey, Ashlei

Office Address (Street, Box, or Route)

7914 W Dodge Road #254

Permanent Residence (Street, Box, or Route)

12037 N 40th

City

Omaha

State

Zip

68114

City

Omaha

State

Zip

68112

Office Phone

(402) 819-9906

Home Phone

(214) 608-8819

Email Address

ashlei@ibeblackgirl.org

PRINCIPAL {49-1480(2)}

Name

I Be Black Girl

Office Phone

(402) 819-9906

Office Address (Street, Box, or Route)

7914 W Dodge Road #254

Official to Whom Lobbyist is Accountable

City

Omaha

State

Zip

68114

Nature of Business {49-1480(3)}

Nonprofit

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

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Reproductive justice

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

Names and addresses of principal's officers:

Ashlei Spivey

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)}

N/A

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

ashleispivey

Lobbyist Name

Dec 5, 2023

Date