Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 18, 2023

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

Crimmins, Michelle

Office Address (Street, Box, or Route)

2900 Ames Crossing Road

Permanent Residence (Street, Box, or Route)

City

Eagan

State

Zip

55121

City

State

Zip

Office Phone

(612) 329-3245

Home Phone

Email Address

michelle.crimmins@primetherapeutics.com

PRINCIPAL {49-1480(2)}

Name

Prime Therapeutics, LLC

Office Phone

(804) 834-2626

Office Address (Street, Box, or Route)

110 Fortress Dr.

Official to Whom Lobbyist is Accountable

David Root

City

O'Fallon

State

Zip

62269

Nature of Business {49-1480(3)}

Pharmacy Benefits Management

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

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} All matters relating to the principal including but not limited to pharmaceuticals, pharmacy benefits management, health care, health insurance, health technology, business and commerce and state budget matters.

Description of industry, trade, profession, or interests and groups represented by the principal:
Pharmacy Benefits Management

Names and addresses of principal's officers:

Mostafa Kamal, President & CEO
2900 Ames Crossing Rd., Eagan, MN, 55121

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.

Michelle Crimmins

Lobbyist Name

Dec 18, 2023

Date