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

Watson, James S.

Office Address (Street, Box, or Route)

6520 Shenandoah Drive

Permanent Residence (Street, Box, or Route)

6520 Shenandoah Drive

City

Lincoln

State

Zip

68510

City

Lincoln

State

Zip

68510

Office Phone

(402) 802-8058

Home Phone

(402) 486-4055

Email Address

jwatiii@outlook.com

PRINCIPAL {49-1480(2)}

Name

Nebraska Association of Medicaid Health Plans

Office Phone

(402) 305-9407

Office Address (Street, Box, or Route)

2525 N 117th Ave Suite 100

Official to Whom Lobbyist is Accountable

Jeff Stafford, President, and NAMHP Board

City

Omaha

State

Zip

68164

Nature of Business {49-1480(3)}

Medicaid Health Coverage

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

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

Description of industry, trade, profession, or interests and groups represented by the principal:
Medicaid Health Benefits

Names and addresses of principal's officers:

Jeff Stafford, President
UNITED HEALTHCARE OF MIDLANDS
2717 N 118TH CIR
OMAHA NE 68164-9688

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)}

none

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

James S. Watson

Lobbyist Name

Dec 28, 2023

Date