Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 20, 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

Wurster, Donald F.

Office Address (Street, Box, or Route)

1314 Douglas Street, Suite 1400

Permanent Residence (Street, Box, or Route)

City

Omaha

State

Zip

68102-1944

City

State

Zip

Office Phone

(402) 916-3200

Home Phone

Email Address

dfwurster@nationalindemnity.com

PRINCIPAL {49-1480(2)}

Name

National Indemnity Company

Office Phone

(402) 916-3000

Office Address (Street, Box, or Route)

1314 Douglas Street, Suite 1400

Official to Whom Lobbyist is Accountable

President

City

Omaha

State

Zip

68102-1944

Nature of Business {49-1480(3)}

INSURANCE

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

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Legislation affecting the taxation of insurance companies.

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

Names and addresses of principal's officers:

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.

Donald F. Wurster

Lobbyist Name

Dec 20, 2023

Date