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

Radcliffe, Walter H. of Radcliffe Gilbertson & Brady

Office Address (Street, Box, or Route)

625 S. 14th Street, Suite 100

Permanent Residence (Street, Box, or Route)

1701 South 33rd

City

Lincoln

State

Zip

68508

City

Lincoln

State

Zip

68506

Office Phone

(402) 476-7272

Home Phone

(402) 488-0609

Email Address

WRadcliffe@RGBLOBBY.com

PRINCIPAL {49-1480(2)}

Name

Woodmen of the World Life Insurance Society and Subordinate Entities

Office Phone

(402) 271-7223

Office Address (Street, Box, or Route)

1700 Farnam Street

Official to Whom Lobbyist is Accountable

Matthew E. Ellis

City

Omaha

State

Zip

68102

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.
60,000.00 Per Year

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Matters that relate to the Insurance Industry

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

Names and addresses of principal's officers:

Patrick L. Dees, President, 1700 Farnam Street, Omaha, NE 68102

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.

whradcliffe

Lobbyist Name

Dec 28, 2023

Date