Nebraska Legislature - Lobbyist Reporting Application

Clerk of the Legislature

Room 2014 State Capitol

PO Box 94604

Lincoln, NE 68509

(402) 471-2608

NEBRASKA LOBBYIST
TERMINATION
OF REGISTRATION

NADC FORM F

Submission Date: Nov 5, 2024

A lobbyist registration expires automatically on December 31^st unless renewed. To terminate a registration prior to December 31^st, a termination of registration must be filed with the Clerk of the Legislature.
A final Quarterly Report must be filed with the termination statement unless there have been no receipts and expenditures since the last Quarterly Report. Both the principal and the lobbyist must file final Quarterly Reports. If the principal has another lobbyist who is not terminating, the principal should not file a final Quarterly Report.
All lobbyists must file a Statement of Activity within 45 days after a Legislative Session even if this statement is on file.

ITEM 1

NATURE OF FILING

For Calendar Year of

2024

ITEM 2

NAME OF LOBBYIST AND PRINCIPAL

LOBBYIST

Lobbyist Name

Faustman, Nicholas

Phone

(402) 260-7907

Address

8790 F St Suite 404

City

Omaha

State

Zip

68114

PRINCIPAL

Principal Name

Alzheimer's Association

Phone

(402) 502-4300

Address (Street, Box, or Route)

11711 Arbor Street; Suite 110

City

Omaha

State

Zip

68114

ITEM 3

TERMINATION INFORMATION (Check Appropriate Box)

The undersigned lobbyist ceased to engage in lobbying activity for the above named principal as of the date stated below. I have had no lobbying receipts from or lobbying expenditures for this principal since the closing date of my last quarterly report. I understand that I must file a Statement of Activity (NADC Form D) within 45 days after the end of the Legislative Session.

The undersigned lobbyist ceased to engage in lobbying activity for the above named principal as of the date stated below. I have received lobbying receipts from or made lobbying expenditures for the principal since the closing date of my last quarterly report and a final quarterly report (NADC Form B) will need to be filed. I understand that I must file a Statement of Activity (NADC Form D) within 45 days after the end of the Legislative Session.

Explanation, if any:

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

Nicholas Faustman

Lobbyist Name

Nov 5, 2024

Date