Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 28, 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

Pollock, Andy

Office Address (Street, Box, or Route)

1128 Lincoln Mall, Ste. 300

Permanent Residence (Street, Box, or Route)

1448 Pioneers Blvd

City

Lincoln

State

Zip

68508

City

Pleasant Dale

State

Zip

68423

Office Phone

(402) 475-5100

Home Phone

(402) 480-0058

Email Address

apollock@remboltlawfirm.com

PRINCIPAL {49-1480(2)}

Name

Rembolt Ludtke, LLP

Office Phone

(402) 475-5100

Office Address (Street, Box, or Route)

1128 Lincoln Mall, Ste. 300

Official to Whom Lobbyist is Accountable

Tara Paulson

City

Lincoln

State

Zip

68508

Nature of Business {49-1480(3)}

Law Firm

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
25,000.00 Per Session

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Legal

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

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.

Andy Pollock

Lobbyist Name

Dec 28, 2023

Date