Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 18, 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

Hayes, Jason W.

Office Address (Street, Box, or Route)

605 S. 14th Street, Suite 200

Permanent Residence (Street, Box, or Route)

4141 Duxhall Drive

City

Lincoln

State

Zip

68508

City

Lincoln

State

Zip

68516

Office Phone

(402) 475-7611

Home Phone

(402) 304-9414

Email Address

jason.hayes@nsea.org

PRINCIPAL {49-1480(2)}

Name

Nebraska State Education Association

Office Phone

(402) 475-7611

Office Address (Street, Box, or Route)

605 S. 14th Street

Official to Whom Lobbyist is Accountable

City

Lincoln

State

Zip

68508

Nature of Business {49-1480(3)}

EDUCATION

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
2,529.00 Per Month

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Issues affecting public education and public school employees

Description of industry, trade, profession, or interests and groups represented by the principal:
Professional organization for Nebraska public school employees

Names and addresses of principal's officers:

Jenni Benson, President, 605 S 14th Street, Lincoln NE 68508
Madaline Fennell, Executive Director, 605 S 14th Street, Lincoln NE 68508

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.

Jason W. Hayes

Lobbyist Name

Dec 18, 2023

Date