Nebraska Legislature - Lobbyist Reporting Application

FORM
A-R

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 28, 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

Kruse Company

Office Address (Street, Box, or Route)

2744 Stratford Ave

Permanent Residence (Street, Box, or Route)

2744 Stratford Ave

City

Lincoln

State

Zip

68502

City

Lincoln

State

Zip

68502

Office Phone

(402) 770-8898

Home Phone

(402) 770-8898

Email Address

daciakruse@gmail.com

PRINCIPAL {49-1480(2)}

Name

Nebraska Alliance for Family and Child Service Providers

Office Phone

Office Address (Street, Box, or Route)

PO Box 22104

Official to Whom Lobbyist is Accountable

Mike Betzold

City

Lincoln

State

Zip

68542

Nature of Business {49-1480(3)}

Family Services

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
2,200.00 Per Month

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Family and Child Welfare Issues

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

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.

Dacia Kruse

Lobbyist Name

Dec 28, 2023

Date