Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 26, 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

Kibbe, Scot

Office Address (Street, Box, or Route)

8700 W Bryn Mawr Avenue, Ste 1200S

Permanent Residence (Street, Box, or Route)

City

Chicago

State

Zip

60631

City

State

Zip

Office Phone

(847) 553-3637

Home Phone

Email Address

scot.kibbe@apci.org

PRINCIPAL {49-1480(2)}

Name

American Property Casualty Insurance Association (APCIA)

Office Phone

(847) 297-7800

Office Address (Street, Box, or Route)

8700 West Bryn Mawr, Suite 1200S

Official to Whom Lobbyist is Accountable

N/A

City

Chicago

State

Zip

60631-3512

Nature of Business {49-1480(3)}

Insurance Trade Association

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

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Any and all matters directly or indirectly relating to insurance industry.

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

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)}

N/A

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

Scot Kibbe

Lobbyist Name

Dec 26, 2023

Date