Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 7, 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

Irsik, Ryan

Office Address (Street, Box, or Route)

10024 Hocker Dr.

Permanent Residence (Street, Box, or Route)

3902 SW Ridgeway St.

City

Merriam

State

Zip

66203

City

Bentonville

State

Zip

72712

Office Phone

(479) 715-1213

Home Phone

(479) 426-9363

Email Address

ryan.irsik@stateandfed.com

PRINCIPAL {49-1480(2)}

Name

Walmart Inc.

Office Phone

(517) 488-4896

Office Address (Street, Box, or Route)

702 SW 8th Street

Official to Whom Lobbyist is Accountable

Nick Infante

City

Bentonville

State

Zip

72716

Nature of Business {49-1480(3)}

Retail

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

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

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

Names and addresses of principal's officers:

Nick Infante: 708 SW 8th St., Bentonville, AR 72716

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.

Ryan Irsik

Lobbyist Name

Dec 7, 2023

Date