Nebraska Legislature - Lobbyist Reporting Application

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Dec 30, 2023 - 1:36 PM
Apr 21, 2024 - 11:34 PM

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Dec 30, 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
Date Amended: Apr 21, 2024

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

Prokop, Matthew

Office Address (Street, Box, or Route)

900 S 74th Plz, Ste 401

Permanent Residence (Street, Box, or Route)

5630 Falcon Circle

City

Omaha

State

Zip

68114

City

Lincoln

State

Zip

68516

Office Phone

(402) 826-7494

Home Phone

(402) 826-7494

Email Address

matt.prokop@als.org

PRINCIPAL {49-1480(2)}

Name

ALS Association

Office Phone

(402) 826-7494

Office Address (Street, Box, or Route)

1300 Wilson Boulevard, Suite 600

Official to Whom Lobbyist is Accountable

Colleen Wachter

City

Arlington

State

Zip

22209

Nature of Business {49-1480(3)}

Non Profit Corporation

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

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} Access to care, prescription drugs, clinical services

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

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.

Matthew Prokop

Lobbyist Name

Apr 21, 2024

Date