Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 11, 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

Zielske, Pamela

Office Address (Street, Box, or Route)

1001 Connecticut Ave. NW, Suite 1230

Permanent Residence (Street, Box, or Route)

1001 Connecticut Ave. NW, Suite 1230

City

Washington

State

Zip

20036

City

Washington

State

Zip

20036

Office Phone

(916) 917-4519

Home Phone

(916) 917-4519

Email Address

pzielske@dialysispatients.org

PRINCIPAL {49-1480(2)}

Name

Dialysis Patient Citizens

Office Phone

(866) 877-4242

Office Address (Street, Box, or Route)

1001 Connecticut Ave., NW, Suite 1230

Official to Whom Lobbyist is Accountable

Hrant Jamgochian

City

Washington

State

Zip

20036

Nature of Business {49-1480(3)}

Nonprofit patient advocacy

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

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Any and all matters that may impact dialysis patients

Description of industry, trade, profession, or interests and groups represented by the principal:
Working to improve the quality of life for dialysis patients

Names and addresses of principal's officers:

Andrew Conkling, President
Natalie Zuniga, Vice-President
Stephen Ahern, Treasurer
Pius Murray, Secretary

Address: 1001 Connecticut Avenue, NW, Suite 1230, Washington D.C. 20036

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.

Pamela Zielske

Lobbyist Name

Dec 11, 2023

Date